The Correlation of Urine Retinol Binding Protein-4 and Serum HbA1c with Glomerular Filtration Rate in Type 1 (Insulin-Dependent) Diabetic Children: A Perspective on the Duration of Diabetes

Objective: To analyze the correlation between urine retinol binding protein-4 (RBP-4) and serum HbA1c?with glomerular filtration rate (GFR) in type 1 diabetic children. Methods:?This?was a crosssectional observational analytic?study. The subjects?were?type 1 diabetic children aged 2 - 14 years. Sample collection was conducted from October to November 2014. Exclusion criteria were patients with obesity, renal insufficiency?that?was not caused by diabetes, history of hepatic diseases, and history of blood cell disorders. We?performed anamnesis, physical examination, and blood sampling for serum HbA1c?and serum cystatin-C, and urine sampling for RBP-4?on all subjects. Glomerular filtration rate was calculated from the concentration level of cystatin-C using Filler formula. Data analysis was performed?by?Spearman test to determine the correlation between urine RBP-4 and serum HbA1c?with GFR. The Fisher’s exact test was used to determine the correlation between duration of diabetes and RBP-4, HbA1c, and also GFR. Results:?Twelve females (60%) and 8 males (40%) participated in the study. The mean age of the subjects with 95% CI?was: 10.5 (2 - 14) years while the mean age of duration diabetes with 95% CI: 3.8 (0.5 - 10) years. Twelve (60%) subjects had?<5 years duration of diabetes, while eight (40%) subjects had?≥5 years duration of diabetes. Twelve (60%) subjects had normal RBP-4 level, while eight (40%) subjects had?elevated RBP-4 level. The mean level of HbA1c?with 95% CI: 8.9 (5.1 - 15.2)%. Thirteen (65%) subjects had poor metabolic. The mean GFR of the subjects with 95% CI: 99.3 (35.2 - 147.4) mL/1.73/m2. Nineteen (95%) subjects had normal GFR, while 1 (5%) had renal insufficiency. The results of data analysis using Spearman test on the correlation between urine RBP-4 and serum HbA1cwith GFR were not significant. The result of correlation between duration of diabetes and urine RBP-4 was significant?using?Fischer’s test. Conclusion:?The results?showed?no correlation between urine RBP-4 and serum HbA1c?with GFR. Urine RBP-4 could?be considered to assess renal function in type 1 diabetic patients with a duration of diabetes of more than 5 years.

NPHS2 Gene Mutation and Polymorphisms in Indonesian Children with Steroid-Resistant Nephrotic Syndrome

Objective:?Although several NPHS2 gene mutations and polymorphisms were described and?associated with clinical manifestation of steroid-resistant nephrotic syndrome (SRNS),?the?occurrence of these genetic abnormalities or variants appeared?to be influenced by race and ethnic group. We have investigated?probable mutations and variants in NPHS2 gene involved in SRNS and their association with clinical manifestations. Methods: We examined 28 children?with primary SRNS?whovisited?the pediatric nephrology division of 10 teaching hospitals in Indonesia. Molecular genetic studies of the NPHS2 gene were?conducted through screenings?for the exon 1, exon 2, and exon 8. The mutational analysis of NPHS2 was performed by DNA sequencing.?Fisher’s Exact Test was used to determine?the?correlation?between?NPHS2 polymorphisms and clinical manifestations.Results:?Seven?females (25%) and 21 males (75%)?participated in the study.?The mean age of the subjects with 95% CI is: 7.6 (6.1 - 9.0) years while the mean age at onset of disease with 95% CI is: 5.4 (3.9 - 7.0) years. Sixteen patients (57.14%) were younger than 6 years at the onset of disease. Seventeen (60.7%) subjects had normal eGFR, while 11 (39.3%) had chronic renal insufficiency. The mean eGFR of the subjects with 95% CI is: 111.4 (87.7 - 135.1) ml/min/1.73 m2. The mean systolic blood pressure with 95% CI is: 117.0 (108.9 - 125.1) mmHg and the mean diastolic blood pressure with 95% CI is: 77.0 (70.3 - 83.7) mmHg.?We identified 6 NPHS2polymorphisms,?i.e.?g.-52G>T, c.101A>G, g.-117C>T, c.288C>T, c.954C>T, and c.1038A>G and no mutation?was found. There was?no correlation?between?NPHS2 polymorphisms and clinical manifestations (p > 0.05). Conclusion: The?results demonstrate no mutation of NPHS2 gene, and the 6 NPHS2 gene polymorphisms that were identified have no correlation with the clinical manifestation in Indonesian children with SRNS.

The Differences of Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels between Asphyxiated and Non-Asphyxiated Neonates

Objective: To evaluate the differences of urinary NGAL levels between asphyxiated and non-as- phyxiated neonates. Methods: This was a cross-sectional observational analytic study, including 34 newborns in Dr. Hasan Sadikin Hospital, Bandung, Indonesia. Sample collection was conducted from December 2014 to March 2015. Urine NGAL levels were evaluated using enzyme-linked immunosorbent assays (ELISA) technique. To determine the differences of urinary NGAL levels between asphyxiated and non-asphyxiated group we used Mann-Whitney U test, and to determine the differences of gestational age and birth weight between these two groups we used Fisher’s exact test. Results: Twenty males (60%) and 14 females (40%) neonates participated in the study. From 34 subjects, 17 neonates were diagnosed with asphyxia and 17 neonates without asphyxia. The results showed that urine NGAL levels had significantly increased in asphyxiated neonates. The median urine NGAL level in asphyxiated group is 95% CI: 506.7 (60.0 - 651.7) ng/mL, while the median urine NGAL level in non-asphyxiated group is 95% CI: 6.7 (0.1 - 53.0) ng/mL. Statistically, there were significant urine NGAL levels differences between asphyxiated and non-asphyxi- ated neonates (p < 0.001). There were no differences in gestational age and birth weight between asphyxiated and non-asphyxiated neonates (p > 0.05). Conclusions: Urinary NGAL levels in asphyxiated neonates were significantly higher than those in non-asphyxiated neonates. There were significant differences of urine NGAL levels between the groups.