Evaluating the Measurement of Urinary Neutrophil Gelatinase Associated Lipocalin for the Diagnosis of Vesicoureteral Reflux in Children

Background: One of the most common urological disorders in childhood is vesicoureteral reflux (VUR) that can lead to kidney injury, scarring and chronic kidney disease. VUR is diagnosed by radiological methods, which are often invasive. We evaluated the possibility of diagnosing VUR by measuring urinary NGAL (Neutrophil gelatinase-Associated Lipocalin) in this study.Methods: This prospective cohort study was conducted on children aged ۱-۵ years old with recurrent urinary tract infections in ۲۰۱۷- ۲۰۱۸ in Sannandaj, Iran. After ruling out other causes of recurrent urinary tract infections, urinary levels of NGAL and creatinine (Cr) were measured in random urine simultaneously with voiding cystourethrography (VCUG). Then the patients were divided into ۲ groups with and without VUR based on VCUG and the collected data were statistically analysed.Results: In this study, ۷۱ children (۱۲-۶۰ months) with a mean age of ۲۳±۳۶.۳۵ months were studied, among whom ۳۴ children had VUR and ۳۷ children did not have VUR. The mean urinary NGAL/Cr ratio in the group with VUR (۳.۴۵ ± ۳.۸ ng/mg) was significantly higher than that in the group without VUR (۱.۱۸± ۰.۸ ng/mg) (P: ۰.۰۰۲). The best cut-off point for urinary NGAL/Cr ratio was ۱.۲۷ ng/mg, with a sensitivity of ۷۶.۵% and specificity of ۷۳% (ROC area: ۰.۷۶, P <۰.۰۰۱).Conclusion: Urinary NGAL/Cr ratio is higher in children with VUR and may be used as a rapid and non-invasive method in the diagnosis of VUR.

Keywords:

Children , Diagnostic method , Neutrophil gelatinase-associated lipocalin , Vesicoureteral reflux