Role of urinary NGAL and KIM-1 as biomarkers of early kidney injury in obese prepubertal children

Nella Polidori; Cosimo Giannini; Roberta Salvatore; Piernicola Pelliccia; Adriana Parisi; Francesco Chiarelli; Angelika Mohn

doi:10.1515/jpem-2020-0138

Article

Role of urinary NGAL and KIM-1 as biomarkers of early kidney injury in obese prepubertal children

Nella Polidori , Cosimo Giannini , Roberta Salvatore , Piernicola Pelliccia , Adriana Parisi , Francesco Chiarelli and Angelika Mohn

Published/Copyright: August 26, 2020

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 33 Issue 9

Abstract

Objectives

Childhood obesity is an important cause of end-stage renal disease. To date, available markers do not characterize kidney changes, especially in the early stages. kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are already detected before the onset of proteinuria or alterations of glomerular filtration rate and thus might represent biomarkers that directly reflect kidney injury.

Methods

We characterize kidney injury in a group of 40 obese-prepubertal children compared to 29-healthy age- and gender matched-peers. Anthropometric measurements and body composition were determined. Fasting blood samples were collected for measurement of insulin, glucose, lipid profile, transaminases, cystatin C and creatinine. Urine samples were collected to assess urinary NGAL, KIM-1 and urinary isoprostanes. Kidney length was measured with ultrasound evaluation. Differences between the two groups were evaluated by Mann–Whitney U test, and Spearman correlation analysis was used to explore relationship between variables.

Results

Triglycerides, alanine transaminase (ALT), glucose, insulin, homeostasis model assessment insulin resistance, triglycerides/high-density lipoprotein (HDL)-cholesterol ratio and cystatin C values were significantly higher in obese children than normal weight peers. Creatinine values were normal and similar between the two groups, while isoprostanes were higher in obese. Obese children had larger kidney sizes, indicating organ hypertrophy. NGAL and KIM-1 were increased in obese children compared to controls. A significant association between NGAL and KIM-1 with adiposity indices, insulin status and markers of oxidative stress postulated a possible effect of obesity in inducing kidney abnormalities. KIM-1 and NGAL are directly related respectively to cystatin C and isoprostanes, supporting the ability of these biomarkers in reflecting early kidney damages in obese subjects.

Conclusions

These findings suggest that obese subjects exhibit a certain degree of renal damage before kidney function loss.

Keywords: early kidney dysfunction; kidney disease; kidney hypertrophy; obesity; oxidative stress

Corresponding author: Angelika Mohn, Department of Pediatrics, University of Chieti, Via Dei Vestini 5, 66100Chieti, Italy, Phone: +39 871 358827, Fax: +39 871 574831, E-mail: amohn@unich.it

Research funding: None declared.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analyses, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Informed consent: Informed consent was obtained from all participating patients or their parents/guardians.
Ethical approval: The study was approved by the Ethical Committee of the University of Chieti, Italy.

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Received: 2020-04-14

Accepted: 2020-06-28

Published Online: 2020-08-26

Published in Print: 2020-09-25

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Articles in the same Issue

https://doi.org/10.1515/jpem-2020-0138

Keywords for this article

early kidney dysfunction; kidney disease; kidney hypertrophy; obesity; oxidative stress