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Determination of early urinary renal injury markers in obese children

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Abstract

Background

Obesity is an important health issue, the prevalence of which is increasing in childhood. The aim of this study was to examine urinary renal injury markers in order to determine the renal effect of obesity and its comorbidities in a pediatric population.

Methods

Eighty-four obese children and 64 healthy control subjects were enrolled in the study. We checked their urine using N-acetyl-beta-d-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and microalbumin as renal injury markers. Associations of renal damage markers with hypertension, an impaired glucose tolerance test, and insulin resistance were assessed.

Results

Obese individuals had higher urinary NAG and KIM-1 values compared to those of healthy controls (p = 0.027, p = 0.026). There was no difference in urinary NGAL between obese and lean subjects (p = 0.885). Urinary renal injury markers were not statistically different in the obese group when checked for impaired glucose tolerance, insulin resistance, and hypertension (p > 0.05).

Conclusions

This study shows that urinary NAG and KIM-1 could be used as a screening method for detection of early renal damage in obese children.

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References

  1. Henegar JR, Bigler SA, Henegar LK, Tyagi SC, Hall JE (2001) Functional and structural changes in the kidney in the early stages of obesity. J Am Soc Nephrol 12:1211–1217

    CAS  PubMed  Google Scholar 

  2. Ross WR, McGill JB (2006) Epidemiology of obesity and chronic kidney disease. Adv Chronic Kidney Dis 13:324–335

    Article  Google Scholar 

  3. Tagle R, Gonzalez F, Acevedo M (2012) Microalbuminuria and urinary albumin excretion in clinical practice. Rev Med Chil 140:797–805

    Article  CAS  PubMed  Google Scholar 

  4. Redon J, Martinez F (2012) Microalbuminuria as surrogate endpoint in therapeutic trials. Curr Hypertens Rep 14:345–349

    Article  CAS  PubMed  Google Scholar 

  5. Thomas MC, Burns WC, Cooper ME (2005) Tubular changes in early diabetic nephropathy. Adv Chronic Kidney Dis 12:177–186

    Article  CAS  PubMed  Google Scholar 

  6. Brito PL, Fioretto P, Drummond K, Kim Y, Steffes MW, Basgen JM, Sisson-Ross S, Mauer M (1998) Proximal tubular basement membrane width in insulin-dependent diabetes mellitus. Kidney Int 53:754–761

    Article  CAS  PubMed  Google Scholar 

  7. Soni SS, Cruz D, Bobek I, Chionh CY, Nalesso F, Lentini P, de Cal M, Corradi V, Virzi G, Ronco C (2010) NGAL: a biomarker of acute kidney injury and other systemic conditions. Int Urol Nephrol 42:141–150

    Article  CAS  PubMed  Google Scholar 

  8. Han KW, Bailly V, Abichandani R, Thadhani R, Bonventre JV (2002) Kidney injury molecule-1(KIM-1): a novel biomarker for human renal proximal tubule injury. Kidney Int 62:237–244

    Article  CAS  PubMed  Google Scholar 

  9. Adiyanti SS, Loho T (2012) Acute kidney injury (AKI) biomarker. Acta Med Indones 44:246–255

    PubMed  Google Scholar 

  10. Kavukçu S, Soylu A, Türkmen M (2002) The clinical value of urinary N-acetyl-β-d-glucosaminidase levels in childhood age group. Acta Med Okayama 56:7–11

    PubMed  Google Scholar 

  11. Mohammadi-Karakani A, Asgharzadeh-Haghighi S, Ghazi-Khansari M, Hosseini R (2007) Determination of urinary enzymes as a marker of early renal damage in diabetic patients. J Clin Lab Anal 21:413–417

    Article  CAS  PubMed  Google Scholar 

  12. Nielsen SE, Schjoedt KJ, Astrup AS, Tarnow L, Lajer M, Hansen PR, Parving HH, Rossing P (2010) Neutrophil gelatinase-associated lipocalcin (NGAL) and kidney injury molecule 1 (KIM1) in patients with diabetic nephropathy: a cross-sectional study and the effects of lisinopril. Diabet Med 27:1144–1150

    Article  CAS  PubMed  Google Scholar 

  13. Bonvente JV (2009) Kidney injury molecule-1 (KIM-1): a urinary biomarker and much more. Nephrol Dial Transplant 24:3165–3168

    Google Scholar 

  14. Cowland JB, Sorensen OE, Sehested M, Borregaard N (2003) Neutrophil gelatinase-associated lipocalcin is up-regulated in human epithelial cells by IL-1β, but not TNF-α. J Immunol 171:6630–6639

    Article  CAS  PubMed  Google Scholar 

  15. Barlow SE, Committee E (2007) Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 120:164–192

    Article  Google Scholar 

  16. Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin N Am 34:571–590

    CAS  Google Scholar 

  17. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of WHO consultation. Diabet Med 15:539–553

    Article  CAS  PubMed  Google Scholar 

  18. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419

    Article  CAS  PubMed  Google Scholar 

  19. Valerio G, Licenziati MR, Iannuzzi A, Franseze A, Siani P, Riccardi G, Rubba P (2006) Insulin resistance and impaired glucose tolerance in obese children and adolescents from southern Italy. Nutr Metab Cardiovasc Dis 16:279–284

    Article  CAS  PubMed  Google Scholar 

  20. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

    Article  Google Scholar 

  21. Siedell JC (2000) Obesity, insulin resistance and diabetes—a worldwide epidemic. Br J Nutr 83:5–8

    Google Scholar 

  22. Yuca SA, Yilmaz C, Cesur Y, Dogan M, Kaya A, Basaranoglu M (2010) Prevalence of overweight and obesity in children and adolescents in eastern Turkey. J Clin Res Pediatr Endocrinol 2:159–163

    Article  PubMed Central  PubMed  Google Scholar 

  23. Krassas GE, Tsametis C, Baleki V, Constantinidis T, Unluhizarci K, Kurtoglu S, Kelestimur F (2004) Balkan group for the study of obesity. Prevalence of overweight and obesity among children and adolescents in Thessaloniki-Greece and Kayseri-Turkey. Pediatr Endocrinol Rev 3:460–464

    Google Scholar 

  24. Ercan S, Dallar YB, Onen S, Engiz O (2012) Prevalence of obesity and associated risk factors among adolescents in Ankara, Turkey. J Clin Res Pediatr Endocrinol 4:204–207

    PubMed Central  PubMed  Google Scholar 

  25. Soylemezoglu O, Duzova A, Yalcinkaya F, Arınsoy T, Suleymanlar G (2012) Chronic renal disease in children aged 5-18 years: a population-based survey in Turkey, the CREDIT-C study. Nephrol Dial Transplant 27:146–151

    Article  Google Scholar 

  26. Ginter E, Simko V (2012) Type 2 diabetes mellitus, pandemic in 21st century. Adv Exp Med Biol 771:42–50

    PubMed  Google Scholar 

  27. Adeghate E, Schattner P, Dunn E (2006) An update on the etiology and epidemiology of diabetes mellitus. Ann N Y Acad Sci 1084:1–29

    Article  PubMed  Google Scholar 

  28. Wofford MR, Hall JE (2004) Pathophysiology and treatment of obesity hypertension. Curr Pharm Des 10:3621–3637

    Article  CAS  PubMed  Google Scholar 

  29. Kordonouri O, Kahl A, Jörres A, Hopfenmüller W, Müller C, Danne T (1999) The prevalence of incipient tubular dysfunction, but not of glomerular dysfunction, is increased in patients with diabetes onset in childhood. J Diabetes Complications 13:320–324

    Article  CAS  PubMed  Google Scholar 

  30. Bolignano D, Lacquaniti A, Coppolino G, Donato V, Fazio MR, Nicocia G, Buemi M (2009) Neutrophil gelatinase-associated lipocalcin as an early biomarker of nephropathy in diabetic patients. Kidney Blood Press Res 32:91–98

    Article  CAS  PubMed  Google Scholar 

  31. Fujita H, Narita T, Morii T, Shimotomai T, Yoshioka N, Kakei M, Ito S (2002) Increased urinary excretion of N-acetylglucosaminidase in subjects with impaired glucose tolerance. Ren Fail 24:69–75

    Article  CAS  PubMed  Google Scholar 

  32. Golov KG, Va V, Dlu O, Neverov NI, Shestakova MV, Proskurneva FP (1995) Urinary enzymes in the assessment of the early stage of kidney involvement in psoriasis and diabetes mellitus. Ter Arkh 67:80–81

    CAS  PubMed  Google Scholar 

  33. Hsiao PH, Tsai WS, Tsai WY, Js L, Tsau YK, Chen CH (1996) Urinary N-acetyl-beta-d-glucosaminidase activity in children with insulin-dependent diabetes mellitus. Am J Nephrol 16:300–303

    Article  CAS  PubMed  Google Scholar 

  34. Savino A, Pelliccia P, Giannini C, Giorgis T, Cataldo I, Chiarelli F, Mohn A (2011) Implications for kidney disease in obese children and adolescents. Pediatr Nephrol 26:749–758

    Article  PubMed  Google Scholar 

  35. Nauta FL, Boertien WE, Bakker SJ, van Goor H, van Oeveren W, de Jong PE, Bilo H, Gansevoort RT (2011) Glomerular and tubular damage markers are elevated in patients with diabetes. Diabetes Care 34:975–981

    Article  PubMed Central  PubMed  Google Scholar 

  36. Bastürk T, Altuntaş Y, Kurklu A, Aydin L, Eren N, Unsal A (2006) Urinary N-acetyl-β glucosaminidase as an earlier marker of diabetic nephropathy and influence of low-dose perindopril/indapamide combination. Ren Fail 28:125–128

    Article  PubMed  Google Scholar 

  37. Hiratsuka N, Shiba K, Nishida K, Lizima S, Kimura M, Kobayashi S (1998) Analysis of urinary albumin, transferring, N-acetyl-β -d-glucosaminidase and β2 microglobulin in patients with impaired glucose tolerance. J Clin Lab Anal 12:351–355

    Article  CAS  PubMed  Google Scholar 

  38. Kern EF, Erhard P, Sun W, Genuth S, Weiss MF (2010) Early urinary markers of diabetic kidney disease: a nested case-control study from the Diabetes Control and Complications Trial(DCCT). Am J Kidney Dis 55:824–834

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  39. Chagnac A, Herman M, Zingerman B, Erman A, Rozen-Zvi B, Hirsh J, Gafter U (2008) Obesity-induced glomerular hyperfiltration: its involvement in the pathogenesis of tubular sodium reabsorption. Nephrol Dial Transplant 23:3946–3952

    Article  CAS  PubMed  Google Scholar 

  40. Duzova A, Yalcinkaya F, Baskin E, Bakkaloğlu A, Soylemezoglu O (2013) Prevalence of hypertension and decreased glomerular filtration rate in obese children: results of a population-based field study. Nephrol Dial Transplant 28:166–171

    Article  Google Scholar 

  41. Ouchi M, Suzuki T, Hashimoto M, Motomoya, Ohara M, Suzuki K, Igari Y, Watanabe K, Nakano H, Oba K (2012) Urinary N-acetyl-β-d-glucosaminidase levels are positively correlated with 2-Hr plasma glucose levels during oral glucose tolerance testing in prediabetics. J Clin Lab Anal 26:473–480

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Schnoell F, Weitgasser R, Straberger A, Pretsch I (1990) Urinary activity of N-acetyl-β-d-glucosaminidase (NAG) in noninsulin-dependent diabetics. Diabetologia 33:A153

    Google Scholar 

  43. Miltenyi M, Körner A, Tulassay T, Szabo A (1985) Tubular dysfunction in type 1 diabetes mellitus. Arch Dis Child 60:929–931

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  44. Quinones-Galvan A, Ferrannini E (1997) Renal effects of insulin in man. J Nephrol 10:188–191

    CAS  PubMed  Google Scholar 

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Acknowledgments

We thank S. Delacroix for English editing of the manuscript.

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey

    Nilufer Goknar & Faruk Oktem

  2. Department of Pediatric Endocrinology and Metabolism, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey

    Ilker Tolga Ozgen & Yasar Cesur

  3. Department of Pediatrics, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey

    Emel Torun, Mehmet Kuçukkoc & Aysegul Dogan Demir

  4. Bezmialem Vakif University Hospital Department of Pediatrics, Adnan Menderes Avenue P.K, 34093, Fatih, Istanbul, Turkey

    Emel Torun

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  1. Nilufer Goknar
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Correspondence to Emel Torun.

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Goknar, N., Oktem, F., Ozgen, I.T. et al. Determination of early urinary renal injury markers in obese children. Pediatr Nephrol 30, 139–144 (2015). https://doi.org/10.1007/s00467-014-2829-0

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  • DOI: https://doi.org/10.1007/s00467-014-2829-0

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