The associations between urinary neutrophil gelatinase-associated lipocalin, ambulatory blood pressure monitoring, echocardiography, and diabetic kidney disease in children
DOI:
https://doi.org/10.15574/PP.2025.3(103).6574Keywords:
diabetic kidney disease, diabetic nephropathy, neutrophil gelatinase-associated lipocalin, childrenAbstract
One of the most common microvascular complications of diabetes is diabetic nephropathy, characterized by pathological alterations in the glomeruli leading to albuminuria, hypertension, and progressive loss of renal function.
This study aimed to determine whether type 1 diabetic nephropathy was present in children by evaluating urinary Neutrophil gelatinase-associated lipocalin (uNGAL) and ambulatory blood pressure monitoring (ABPM).
Materials and methods. A cross-sectional study was conducted from July 2023 to July 2024 and included 57 children with type 1 DM who were subdivided into two groups: Group 1 - 36 children without diabetic kidney disease (non-DKD), and Group 2 - 21 children with DKD. All participants underwent history taking, clinical examination, and laboratory investigations, including CBC, urea, creatinine, HbA1c, albumin/creatinine ratio, NGAL, echocardiography, and ABPM.
Results. The mean uNGAL level was significantly higher in Group 2 (10.43±18.71 pg/ml) compared with Group 1 (1.56±1.31 pg/ml) (P=0.006). The mean overall and daytime systolic and diastolic blood pressures were also significantly higher in Group 2 (DKD) compared with Group 1 (non-DKD) (P<0.01), as measured by ABPM. In addition, Group 2 had significantly lower LVESD (P=0.008), indicating left ventricular systolic dysfunction.
Conclusion. As NGAL is an early indicator of DKD, our findings highlight its predictive importance. In addition, the significantly higher systolic and diastolic blood pressures, along with left ventricular systolic dysfunction in the DKD group, underscore the importance of ABPM and echocardiography in the assessment and follow-up of children with type 1 DM.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the institution’s local ethics committee. The informed consent was obtained from patients.
The authors declare no conflict of interest.
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