Urinary C-megalin for screening of renal scarring in children after febrile urinary tract infection

• Published in: Pediatric research 2018-03, Vol.83 (3), p.662-668
• Main Authors: Yamanouchi, Sohsaku, Kimata, Takahisa, Kino, Jiro, Kitao, Tetsuya, Suruda, Chikushi, Tsuji, Shoji, Kurosawa, Hiroyuki, Hirayama, Yoshiaki, Saito, Akihiko, Kaneko, Kazunari
• Format: Article
• Language: English
• Subjects: 692/4022/1585; 692/53/2421; 692/699/2768/1865; 692/700/1720/3187; Acetylglucosaminidase - urine; beta 2-Microglobulin - urine; Biomarkers - urine; Case-Control Studies; Child; Child, Preschool; Children & youth; clinical-investigation; Creatinine - urine; Fatty Acid-Binding Proteins - urine; Female; Fever - complications; Fever - urine; Humans; Infant; Kidney - diagnostic imaging; Kidney - injuries; Kidney Diseases - diagnostic imaging; Kidney Diseases - etiology; Kidney Diseases - urine; Kidneys; Lipocalin-2 - urine; Low Density Lipoprotein Receptor-Related Protein-2 - analysis; Male; Medicine; Medicine & Public Health; Pediatric Surgery; Pediatrics; Proteins; Radionuclide Imaging; Risk Factors; Scars; Scintigraphy; Sensitivity and Specificity; Urinalysis - methods; Urinary tract diseases; Urinary tract infections; Urinary Tract Infections - complications; Urinary Tract Infections - urine; Urogenital system
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1038/pr.2017.276

Background Febrile urinary tract infection (fUTI) in children may cause renal scarring. This study aimed to investigate the usefulness of urinary biomarkers for diagnosing renal scarring after fUTI. Methods Thirty-seven children (median age: 1.36 years, range: 0.52–12.17 years, 25 boys) with a history of fUTI, who underwent renal scintigraphy for 4 months or longer after the last episode of fUTI, were analyzed. A spot urine sample was obtained on the day of renal scintigraphy to measure levels of total protein, N -acetyl-β- D -glucosaminidase (NAG), β 2 -microglobulin (BMG), neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid binding protein (L-FABP), and C-megalin (full-length megalin). Results were corrected for urinary creatinine (Cr) and compared between the group with renal scarring ( n =23) and that without scarring ( n =14). Urinary levels of C-megalin were also measured in healthy control subjects. Results No significant differences in total protein, NGAL, L-FABP, NAG, and BMG levels were found between the groups. However, C-megalin levels were significantly higher in the renal scarring group than in the non-renal scarring group and healthy controls ( P