Urinary C-megalin for screening of renal scarring in children after febrile urinary tract infection

作者：Yamanouchi Sohsaku; Kimata Takahisa; Kino Jiro; Kitao Tetsuya; Suruda Chikushi; Tsuji Shoji; Kurosawa Hiroyuki; Hirayama Yoshiaki; Saito Akihiko; Kaneko Kazunari^*

来源：Pediatric Research, 2018, 83(3): 662-668.

DOI：10.1038/pr.2017.276

BACKGROUND: Febrile urinary tract infection (fUTI) in children may cause renal scarring. This study aimed to investigate the usefulness of urinary biomarkers for diagnosing renal scarring after fUTI.
METHODS: Thirty-seven children (median age: 1.36 years, range: 0.52-12.17 years, 25 boys) with a history of fUTI, who underwent renal scintigraphy for 4 months or longer after the last episode of fUTI, were analyzed. A spot urine sample was obtained on the day of renal scintigraphy to measure levels of total protein, N-acetyl-beta-D-glucosaminidase (NAG), beta(2)-micro-globulin (BMG), neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid binding protein (L-FABP), and C-megalin (full-length megalin). Results were corrected for urinary creatinine (Cr) and compared between the group with renal scarring (n = 23) and that without scarring (n = 14). Urinary levels of C-megalin were also measured in healthy control subjects.
RESULTS: No significant differences in total protein, NGAL, L-FABP, NAG, and BMG levels were found between the groups. However, C-megalin levels were significantly higher in the renal scarring group than in the non-renal scarring group and healthy controls (P<0.001). A cutoff value of 6.5 pmol/nmol of urinary C-megalin/Cr yielded 73.9% of specificity and 92.9% of sensitivity.
CONCLUSION: Urinary C-megalin is useful for diagnosing renal scarring caused by fUTI.

• 出版日期2018-3