Analysis of the association between kidney injury biomarkers concentration and nephritis in immunoglobulin A vasculitis: A pediatric cohort study

• Published in: International journal of rheumatic diseases Vol. 23; no. 9; pp. 1184 - 1193
• Main Authors: Dyga, Katarzyna, Machura, Edyta, Świętochowska, Elżbieta, Szczepańska, Maria
• Format: Journal Article
• Language: English
• Published: Richmond Wiley Subscription Services, Inc 01-08-2020
• Subjects: Biomarkers; Children; Cohort analysis; Epidemiology; Fatty acid-binding protein; Gelatinase; IgA vasculitis; Immunoglobulin A; Immunoglobulins; Kidneys; KIM‐1; Laboratories; Lipocalin; L‐FABP; Nephritis; NGAL; Patients; Vasculitis
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.13904

Objective
The aim of this study was to investigate the clinical course, selected biochemical parameters and concentrations of renal injury biomarkers such as neutrophil gelatinase‐associated lipocalin (NGAL), kidney injury molecule‐1 (KIM‐1) and liver‐fatty acid binding protein (L‐FABP) in patients with immunoglobulin A vasculitis (IgAV) to identify the markers associated with nephritis in the course of the disease (IgAVN).
Methods
The study involved 29 children with IgAV and 34 healthy controls. Eleven (38%) patients had renal involvement (IgAV‐N) and 18 (62%) did not exhibit nephritis (IgAV‐noN). Initial laboratory tests, determining the concentrations of NGAL, KIM‐1 and L‐FABP in serum and urine, were conducted on children from the study group in an acute phase of IgAV as well as after an average of 6 months, during a follow‐up visit. The interconnection between renal involvement, anthropometric measurements, epidemiological data, laboratory parameters and levels of examined biomarkers have been thoroughly evaluated.
Results
The serum and urine levels of NGAL, KIM‐1 and L‐FABP were significantly higher in children with an acute phase of IgAV as compared to the control group (P < .001) and markedly lower during follow‐up retesting in comparison with the values obtained at inclusion (P < .001). However, the concentration of none of the evaluated biomarkers correlated with nephrological indices. Among all examined parameters, only male subjects were associated with nephritis (P = .017).
Conclusions
We have established no evident association between the concentrations of NGAL, KIM‐1 and L‐FABP and nephritis in the course of IgAV in children. Additionally, we confirmed a significant male predominance in patients with nephritis.