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Urinary NGAL deficiency in recurrent urinary tract infections.

Urinary NGAL deficiency in recurrent urinary tract infections.

Authors :
Forster, Catherine
Johnson, Kathryn
Patel, Viral
Wax, Rebecca
Rodig, Nancy
Barasch, Jonathan
Bachur, Richard
Lee, Richard
Source :
Pediatric Nephrology; Jun2017, Vol. 32 Issue 6, p1077-1080, 4p, 1 Chart
Publication Year :
2017

Abstract

Introduction: Children with recurrent urinary tract infections (rUTI) often show no identifiable cause of their infections. Neutrophil gelatinase-associated lipocalin (NGAL) is known to be upregulated within the uroepithelium and kidney of patients with UTI and exhibits a localized bacteriostatic effect through iron chelation. We hypothesize that some patients with rUTI without an identifiable cause of their recurrent infections have locally deficient NGAL production. We therefore explored whether a lack of NGAL production may be a factor in the pathogenesis of rUTI. Materials and methods: Patients seen in the urology clinic for rUTI who were <21 years of age were enrolled. Patients were excluded if they had UTI at the time of enrollment, evidence of renal disease, decreased renal function, known anatomic abnormality of the genitourinary tract, or other reasons that predispose to UTI, such as neurogenic bladder, the need for intermittent catheterization, or unrepaired posterior urethral valves. Control patients were healthy children enrolled from the emergency department with no history of UTI or renal dysfunction, normal urinalysis at the time of enrollment, and presenting no diagnosis associated with increased NGAL levels, such as acute kidney injury or infection. NGAL was measured by immunoblot. Results: Fifteen cases and controls were enrolled. Median urinary NGAL levels were significantly decreased in rUTI patients compared with controls [15 (14-29) ng/ml vs 30 (27-61) ng/ml; p = 0.002)] Although comparatively diminished, measurable NGAL levels were present in all patients with rUTI. Conclusions: Urinary NGAL is significantly decreased in patients with compared with patients without rUTI. These data suggest that some patients with rUTI may be predisposed to UTI because of a relative local deficiency in urinary NGAL production. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
0931041X
Volume :
32
Issue :
6
Database :
Complementary Index
Journal :
Pediatric Nephrology
Publication Type :
Academic Journal
Accession number :
122598298
Full Text :
https://doi.org/10.1007/s00467-017-3607-6