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2017 ; 32
(3
): 377-381
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Neutrophil gelatinase-associated lipocalin: utility in urologic conditions
#MMPMID27785626
Forster CS
; Devarajan P
Pediatr Nephrol
2017[Mar]; 32
(3
): 377-381
PMID27785626
show ga
Neutrophil gelatinase-associated lipocalin (NGAL) is best known as a non-invasive
early marker of acute kidney injury (AKI). However, recent published reports have
described additional utility of both plasma NGAL (pNGAL) and urine NGAL (uNGAL)
in various pathologic conditions within the pediatric urinary tract, including
urinary tract infection, vesicoureteral reflux (VUR), renal scarring, and
obstructive uropathy. These two forms of NGAL have different applications related
to their mechanisms of upregulation: pNGAL can serve as a marker of systemic
inflammatory conditions, whereas uNGAL is specific for insults to the renal
epithelium. Therefore, pNGAL has good predictive accuracy in systemic
inflammation associated with pyelonephritis and renal damage, while uNGAL is an
effective marker for identifying infection within the genitourinary environment
as well as subclinical renal damage as a result of scarring or obstruction.
Continued work should focus on the effect of trending NGAL values in patients
with pyelonephritis, VUR, and hydronephrosis, to determine if longitudinal NGAL
patterns have value in predicting adverse outcomes.