Early Diagnostic Value Of Urinary NGAL,Serum NGAL,and Urinary RBP On Acute Kidney Injury In Children With Henoch-sch(?)nlein Purpura

Objectives:1. To study the level of the serum neutrophilgelatinase associated lipocalinz (sNAGL), urinary neutrophil gelatinaseassociated lipocalin(uNAGL), urinary retinol binding protein(uRBP) in childrenwith henoch-schonlein purpura (HSP) and henoch-schonlein purpuriticnephritis (HSPN) and their value to predict acute kidney injury in children withHSP.2. To discuss the correlation of the sNAGL, uNAGL and uRBP,andstudy whether their sensibility to predict acute kidney injury is higher thanurine microalbumin, urine β2microglobulin.Methods:60children with HSP were divided into experimental group，and30healthy children into normal control group. On the first day of admission,3mlvenous blood was drawn from the patients with HSP before treatment，andcentrifuged, selected supernatants and preserved in refrigerator at-80℃, testedthe level of sNAGL. On the second morning,10ml urine were taken from thepatients and preserved in refrigerator at-80℃, tested the level of uNAGL,uRBP,urine microalbumin (uMA) and urine β2microglobulin (uβ2-MG).30normal children were taken the same specimens and tested the same. Accordingto their value of uMA and uβ2-MG, the patients were divided into HSPN group(with renal injury,34cases) and non-HSPN group (26cases). In addition, thepatients were followed up and tested the same after discharged for half a month. Results:1. The average level of uNAGL, uRBP, sNAGL, uMA and uβ2-MGin children with non-HSPN were (0.1370±0.0256)mg/L,(0.1566±0.0386)mg/L,(0.786±0.123)mg/L,(10.44±2.33)mg/L,(0.171±0.047)mg/L. The average levelof uNAGL, uRBP, sNAGL, uMA and uβ2-MG in children with HSPN were(0.1370±0.0256)mg/L,(0.1566±0.0386)mg/L,(1.430±0.342)mg/L,(37.19±9.84)mg/L,(0.704±0.205)mg/L. The average level of uNAGL, uRBP, sNAGL,uMA and uβ2-MG in the normal group were (0.0108±0.0029)mg/L,(0.0499±0.0206)mg/L,(0.166±0.054)mg/L,(9.39±1.17)mg/L,(0.157±0.019)mg/L. The levels of all indexes in children with HSPN were higher thanthat in normal children, which were statistically significant(P<0.01). The levelof uNAGL, uRBP, sNAGL, uMA and uβ2-MG in HSPN group were higherthan that in non-HSPN group with significant difference(P<0.01). The level ofuNAGL, uRBP, sNAGL, uMA and uβ2-MG in non-HSPN group were higherthan that in the normal group with significant difference(P<0.01）. The level ofuNGAL, sNGAL, uRBP in the HSPN visited group were still higher than thatin the normal children with significant difference(P<0.01). The level ofuNGAL, sNGAL, uRBP in the non-HSPN visited group were still higher thanthat in the normal children with significant difference(P<0.01).2.All indexeshad positive correlation with each other with significant difference(p<0.001);uNGAL had positive correlation with sNGAL、uRBP、uMA、uβ2-MG, whichwas significant difference(p<0.001); sNGAL had positive correlation withuNGAL、uRBP、uMA、uβ2-MG, which was significant difference(p<0.001);uRBP had positive correlation with sNGAL、uNGAL、uMA、uβ2-MG, which was significant difference(p<0.001); The level of uNAGL, uRBP, sNAGL inchildren with HSP increased along with the raised level of uMA and uβ2-MGand positive correlated with each other. Conclusions:1. The level of sNGAL,uNGAL, uRBP, uMA, urinary β2-MG in the HSPN children and non-HSPNgroup were higher than in normal group, and highly correlated with the acutekidney injury in patients with HSP.2. The level of sNGAL, uNGAL, uRBP inHSPN visited group were higher than that in normal children, they aremonitoring indexes to test kidney function for the HSPN who was discharge.3.The level of uNGAL, sNGAL, uRBP was more sensitive to predict acutekidney injury than uMA and uβ2-MG.4. Joint application of the aboveparameters could improve the accuracy to judge the acute kidney injury inpatients with HSP.