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Urinary NGAL is a useful clinical biomarker of HIV-associated nephropathy.
Nephrol Dial Transplant. 2011 Jul; 26(7):2387-90.ND

Abstract

BACKGROUND

Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is expressed by kidney tubules that are acutely damaged, but few studies have investigated the association of neutrophil gelatinase-associated lipocalin (NGAL) with different forms of chronic kidney disease (CKD). HIV-associated nephropathy (HIVAN) is a progressive form of CKD characterized by collapsing focal segmental glomerulosclerosis and microcytic tubular dilatation that typically leads to end-stage renal disease (ESRD).

METHODS

Previously, we reported that microcystic tubular dilatations specifically expressed NGAL RNA, implying that the detection of uNGAL protein could mark advanced HIVAN. To test this idea, we performed a comparative study of diverse proteinuric glomerulopathies in 25 patients who were HIV positive.

RESULTS

Eighteen patients had HIVAN and seven had other glomerulopathies (four membranoproliferative glomerulonephritis, one membranous glomerulonephritis, one amyloid and one malarial GN). HIVAN and non-HIVAN patients did not differ with respect to age, ethnicity, serum creatinine, estimated GFR, proteinuria or the prevalence of hypocomplementemia (6 versus 29%, P = 0.18), but HIVAN patients were less likely to have HCV infections. HIVAN patients expressed 4-fold higher levels of uNGAL than the patients with other glomerulopathies [387 ± 338 versus 94 ± 101 μg/g urine creatinine (uCr), P = 0.02]. A cutpoint of 121.5 μg uNGAL/g uCr demonstrated 94% sensitivity and 71% specificity for the diagnosis of HIVAN, with an area under the receiver operator characteristic curve of 0.88.

CONCLUSION

In summary, while HIVAN disease is currently diagnosed only by kidney biopsy, uNGAL can distinguish HIVAN from other proteinuric glomerulopathies in the HIV-infected patient, likely because of its specific expression from characteristic microcysts.

Authors+Show Affiliations

Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21555394

Citation

Sola-Del Valle, David A., et al. "Urinary NGAL Is a Useful Clinical Biomarker of HIV-associated Nephropathy." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 26, no. 7, 2011, pp. 2387-90.
Sola-Del Valle DA, Mohan S, Cheng JT, et al. Urinary NGAL is a useful clinical biomarker of HIV-associated nephropathy. Nephrol Dial Transplant. 2011;26(7):2387-90.
Sola-Del Valle, D. A., Mohan, S., Cheng, J. T., Paragas, N. A., Sise, M. E., D'Agati, V. D., & Barasch, J. (2011). Urinary NGAL is a useful clinical biomarker of HIV-associated nephropathy. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 26(7), 2387-90. https://doi.org/10.1093/ndt/gfr258
Sola-Del Valle DA, et al. Urinary NGAL Is a Useful Clinical Biomarker of HIV-associated Nephropathy. Nephrol Dial Transplant. 2011;26(7):2387-90. PubMed PMID: 21555394.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary NGAL is a useful clinical biomarker of HIV-associated nephropathy. AU - Sola-Del Valle,David A, AU - Mohan,Sumit, AU - Cheng,Jen-Tse, AU - Paragas,Neal A, AU - Sise,Meghan E, AU - D'Agati,Vivette D, AU - Barasch,Jonathan, Y1 - 2011/05/09/ PY - 2011/5/11/entrez PY - 2011/5/11/pubmed PY - 2011/11/1/medline SP - 2387 EP - 90 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 26 IS - 7 N2 - BACKGROUND: Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is expressed by kidney tubules that are acutely damaged, but few studies have investigated the association of neutrophil gelatinase-associated lipocalin (NGAL) with different forms of chronic kidney disease (CKD). HIV-associated nephropathy (HIVAN) is a progressive form of CKD characterized by collapsing focal segmental glomerulosclerosis and microcytic tubular dilatation that typically leads to end-stage renal disease (ESRD). METHODS: Previously, we reported that microcystic tubular dilatations specifically expressed NGAL RNA, implying that the detection of uNGAL protein could mark advanced HIVAN. To test this idea, we performed a comparative study of diverse proteinuric glomerulopathies in 25 patients who were HIV positive. RESULTS: Eighteen patients had HIVAN and seven had other glomerulopathies (four membranoproliferative glomerulonephritis, one membranous glomerulonephritis, one amyloid and one malarial GN). HIVAN and non-HIVAN patients did not differ with respect to age, ethnicity, serum creatinine, estimated GFR, proteinuria or the prevalence of hypocomplementemia (6 versus 29%, P = 0.18), but HIVAN patients were less likely to have HCV infections. HIVAN patients expressed 4-fold higher levels of uNGAL than the patients with other glomerulopathies [387 ± 338 versus 94 ± 101 μg/g urine creatinine (uCr), P = 0.02]. A cutpoint of 121.5 μg uNGAL/g uCr demonstrated 94% sensitivity and 71% specificity for the diagnosis of HIVAN, with an area under the receiver operator characteristic curve of 0.88. CONCLUSION: In summary, while HIVAN disease is currently diagnosed only by kidney biopsy, uNGAL can distinguish HIVAN from other proteinuric glomerulopathies in the HIV-infected patient, likely because of its specific expression from characteristic microcysts. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/21555394/Urinary_NGAL_is_a_useful_clinical_biomarker_of_HIV_associated_nephropathy_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfr258 DB - PRIME DP - Unbound Medicine ER -