Association of plasma neutrophil gelatinase-associated lipocalin with parameters of CKD-MBD in maintenance hemodialysis patients.

Abstract

INTRODUCTION:

Neutrophil gelatinase-associated lipocalin (NGAL) is not only a biomarker of kidney injury but also a bone-derived factor involved in metabolism. We aimed to explore relationships between plasma NGAL and chronic kidney disease-mineral bone disorder (CKD-MBD) parameters in maintenance hemodialysis (MHD) patients.

MATERIALS AND METHODS:

First, a cross sectional observational study, including 105 MHD patients, was conducted to explore relationships between plasma NGAL levels and CKD-MBD parameters. Second, impact of parathyroidectomy and auto-transplantation (PTX + AT) on plasma NGAL was investigated in 12 MHD patients with severe secondary hyperparathyroidism (SHPT).

RESULTS:

According to Spearman correlation analysis, plasma NGAL levels were positively correlated with female (r = 0.243, P = 0.012), vintage (r = 0.290, P = 0.003), Klotho (r = 0.234, P = 0.016), calcium(Ca) (r = 0.332, P = 0.001), alkaline phosphatase (ALP) (r = 0.401, P < 0.001) and intact parathyroid hormone (iPTH) (r = 0.256, P = 0.008); while inversely correlated with albumin(Alb) (r = - 0.201, P = 0.039). After adjusting for age, sex, vintage, Alb and all parameters of CKD-MBD(Ca, P, lg(ALP), lg(iPTH), Klotho and fibroblast growth factor 23(FGF23)), lg(NGAL) were positively correlated with Ca (r = 0.481, P < 0.001), P (r = 0.336, P = 0.037), lg(ALP) (r = 0.646, P < 0.001) in Partial correlation analysis; further multiple linear regression analysis showed same positive associations between lg(NGAL) and Ca (β = 0.330, P = 0.002), P (β = 0.218, P = 0.037), lg(ALP) (β = 0.671, P < 0.001). During the 4-7 days after PTX + AT, plasma NGAL decreased from 715.84 (578.73, 988.14) to 688.42 (660.00, 760.26) ng/mL (P = 0.071), Klotho increased from 496.45 (341.73, 848.30) to 1138.25 (593.87, 2009.27) pg/mL (P = 0.099).

CONCLUSION:

Plasma NGAL levels were positively associated with ALP in MHD patients; and downtrends were shown after PTX + AT in patients with severe SHPT. These findings suggest that NGAL is a participant in CKD-MBD under MHD condition.

• Authors: Xiao-Yan Jia, Kai Wei, Juan Chen, Lin-He Xi, Xiang-Lei Kong, Yong Wei, Li Wang, Zun-Song Wang, Yi-Peng Liu, Li-Ming Liang, Dong-Mei Xu
• Journal: Journal of bone and mineral metabolism (J Bone Miner Metab) Vol. 39 Issue 6 Pg. 1058-1065 (Nov 2021) ISSN: 1435-5604 [Electronic] Japan
• PMID: 34392464 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2021. The Japanese Society Bone and Mineral Research.

Chemical References

• Biomarkers
• FGF23 protein, human
• LCN2 protein, human
• Lipocalin-2
• Fibroblast Growth Factor-23

Topics

• Biomarkers
• Chronic Kidney Disease-Mineral and Bone Disorder
• Cross-Sectional Studies
• Female
• Fibroblast Growth Factor-23
• Humans
• Lipocalin-2 (blood)
• Renal Dialysis
• Renal Insufficiency, Chronic (complications, therapy)