Urinary neutrophil-gelatinase associated lipocalin is a more prognostic biomarker to distinguish antenatal hydronephrosis in neonates

Background and aim: routine diagnostic methods of vesicoureteral reflux(vur) are invasive and can cause exposure to radiation and may increase risk ofurinary tract infections. therefore, introducing reliable, non invasive methodsmight be more interested in pediatric nephrology. the objective of thisperospective case control study was to evaluate the prognostic value of urinaryneutrophil-gelatinase associated lipocalin (ungal) on antenatal hydronephrosis(ah) with and without vur.methods: a total of 50 patients diagnosed with ah; 78% males with mean age5.71± 2.1 years, including 27 ah with vur and 23 ah without vur, and 19normal healthy children; 78.9% males with mean age 5.63 ± 1.89 years, wereenrolled in this study. urinary ngal levels were measured by enzyme linkedimmunosorbent assay (elisa).results: there was a significant difference in ungal concentration betweenah patients and controls (0.80 ± 0.26 and 0.29 ± 0.27 ng/ml, p < 0.0001).however, the levels of ungal was not significantly deviated between ahpatients with vur compared to those without vur (0.84 ± 0.34 vs. 0.75 ± 0.13,p=0.419). standardization of ngal based on urinary creatinine (ungal/ucr)showed a significantly difference between ah neonates with vur compared tothose without vur (2.43±1.61 vs. 1.91±0.79, p < 0.0001). receiver operatorcharacteristic (roc) analysis revealed higher prognostic power of ungal foridentifying ah with a sensitivity; 95.7%, and specificity; 84.2%. meanwhile,the levels of ungal or ngal/ucr ratio did not correlate with reflux grade orlaterality.conclusions: the urinary level of ngal and ngal/cr ratio might be asurrogate non invasive, reliable tool to distinguish hydronephrosis.