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Applicability of Novel Urinary Biomarkers for the Assessment of Renal Injury in Selected Occupational Groups in Sri Lanka: A Comparative Study with Conventional Markers

Author

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  • E. M. D. V. Ekanayake

    (Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND 58203, USA)

  • T. D. K. S. C. Gunasekara

    (Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka)

  • P. Mangala C. S. De Silva

    (Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka)

  • Sudheera Jayasinghe

    (Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Galle 80000, Sri Lanka)

  • E. P. S. Chandana

    (Department of Biosystems Technology, Faculty of Technology, University of Ruhuna, Matara 81000, Sri Lanka)

  • Nishad Jayasundara

    (The Nicholas School of the Environment, Duke University, Durham, NC 27708, USA)

Abstract

Screening approaches with more robust biomarkers, are of the utmost importance in the characterization of renal injuries, particularly among communities with high burdens of chronic kidney disease of uncertain etiology (CKDu). The present study aimed to assess the utility of two emerging biomarkers: kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in predicting renal injury in different occupational groups in Sri Lanka. A cross-sectional study was conducted with six occupational groups ( n = 188): fisherfolk (FF), paddy farmers (PF), sugarcane farmers (SF), factory workers (FW) and plantation workers (PW) to assess the predictive performance of KIM-1 and NGAL against a CKDu patient (PT) group ( n = 40). The median KIM-1 levels of the study groups; FF, PF, SF, FW, PW and PT were 0.67, 0.59, 0.49, 1.62, 0.67 and 5.24 ng/mgCr, respectively, while the median NGAL levels were 1.16, 2.52, 1.42, 1.71, 1.06 and 22.41 ng/mgCr respectively. In ROC analysis to predict CKDu susceptibility, the area under the curve for KIM-1 ranged from 0.88 to 0.99 for the study groups, and in overall analysis, the sensitivity and specificity were 100% and 96%, respectively, for a cutoff value of 2.76 ng/mgCr. Similarly, for NGAL the range of AUC was 0.78–0.94, and a cutoff value of 3.12 ng/mgCr produced 88% sensitivity and 82% specificity. Compared with conventional markers, KIM-1 was the best biomarker for the characterization of renal injury in the participants of the occupational groups. With further validations, KIM-1 may be adopted as a prognostic marker to identify early renal injury and CKDu susceptibilities in community screening.

Suggested Citation

  • E. M. D. V. Ekanayake & T. D. K. S. C. Gunasekara & P. Mangala C. S. De Silva & Sudheera Jayasinghe & E. P. S. Chandana & Nishad Jayasundara, 2022. "Applicability of Novel Urinary Biomarkers for the Assessment of Renal Injury in Selected Occupational Groups in Sri Lanka: A Comparative Study with Conventional Markers," IJERPH, MDPI, vol. 19(9), pages 1-15, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:9:p:5264-:d:802530
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    References listed on IDEAS

    as
    1. de Silva, M.W. Amarasiri & Albert, Steven M. & Jayasekara, J.M.K.B., 2017. "Structural violence and chronic kidney disease of unknown etiology in Sri Lanka," Social Science & Medicine, Elsevier, vol. 178(C), pages 184-195.
    2. T.D.K.S.C. Gunasekara & P. Mangala C.S. De Silva & Chula Herath & Sisira Siribaddana & Nipuna Siribaddana & Channa Jayasumana & Sudheera Jayasinghe & Maria Cardenas-Gonzalez & Nishad Jayasundara, 2020. "The Utility of Novel Renal Biomarkers in Assessment of Chronic Kidney Disease of Unknown Etiology (CKDu): A Review," IJERPH, MDPI, vol. 17(24), pages 1-21, December.
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