Abstract: FR-PO470

Urinary Neutrophil Gelatinase-Associated Lipocalin Is a Possible Indicator of Tubulointerstitial Fibrosis and Glomerular Sclerosis in the Patients Undergoing Renal Biopsy

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Hamasaki, Yoshifumi, The University of Tokyo, Tokyo, Japan
  • Yoshida, Teruhiko, The University of Tokyo, Tokyo, Japan
  • Matsuura, Ryo, The University of Tokyo, Tokyo, Japan
  • Tojo, Akihiro, The University of Tokyo, Tokyo, Japan
  • Noiri, Eisei, The University of Tokyo, Tokyo, Japan
  • Nangaku, Masaomi, The University of Tokyo, Tokyo, Japan
Background

Renal tubulointerstitial fibrosis and glomerular sclerosis are common pathological changes occurring in association with chronic kidney disease (CKD). Non-invasive and reliable biomarkers which can predict the renal histopathological change will be helpful to decide the indication of renal biopsy. Neutrophil gelatinase-associated lipocalin (NGAL) is a promising marker of not only acute kidney injury but also CKD. We investigated whether urinary markers, including NGAL, can predict renal tubulointerstitial fibrosis (TF) and glomerular sclerosis (GS) in the patients undergoing percutaneous renal biopsy.

Methods

This study enrolled all consecutive adult patients undergone renal biopsy at The University of Tokyo Hospital from July 2014 to April 2017. We collected urine from these patients just before renal biopsy and measured N-Acetyl-β-D Glucosaminidase, L-type fatty acid binding protein, and NGAL. All markers were corrected by urinary creatinine (Cre) concentration. We also collected clinical parameters measured before renal biopsy. All biopsy specimens were evaluated by a pathologist for the medical purpose. We evaluated the relationships between urinary markers and the results of histopathological diagnoses.

Results

Ninety-six patients were enrolled in this study. Urinary NGAL/Cre (uNGAL/Cre) was significantly correlated with the severity of TF and the percentage of sclerotic glomeruli (Spearman's rank correlation coefficient ρ= 0.38 and 0.28, p <0.01 and <0.01, respectively) in the biopsy specimens. uNGAL/Cre was also significantly correlated with eGFR. When all patients were divided into two groups according to the severity of TF (less or more than 10% of interstitial area) or GS (less or more than 30% of total number of glomeruli), uNGAL/Cre in the severe group was significantly higher than in the mild group. When data from the patients with positive urine dipstick for both blood and protein (greater than 1+) were analyzed, uNGAL/Cre predicted severe TF and GS on ROC analysis (AUC [95%CI] = 0.72 [0.59-0.84] and 0.70 [0.56-0.83], respectively).

Conclusion

uNGAL/Cre may predict the severity of tubulointerstitial fibrosis and glomerular sclerosis in the patients undergoing renal biopsy.