الفهرس 
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Abstract
Neutrophil gelatinase - associated lipocalin (NGAL) also named Human neutrophil lipocalin (HNL), is a glycoprotein which exists as 25-kDa monomer belonging to the lipocalin superfamily.
Neutrophil gelatinase - associated lipocalin was originally identified in and purified from human neutrophils, it is also generally expressed at very low concentrations in a wide range of human tissues including kidney, trachea, lungs, stomach and colon.
Neutrophil gelatinase - associated lipocalin was initially found in activated neutrophils, however, many other cells like kidney tubular cells, may produce NGAL in response to various insults. Recently, it has been found to have a role in iron metabolism by virtue of its binding with siderophores. It has also been found to have a role in kidney development and tubular regeneration after injury.
In this study, our goal was to evaluate serum and urine levels of NGAL in children with chronic relapsing nephrotic syndrome and to enlighten its role as sensitive marker of renal injury detecting severity of renal impairment .we hypothesise that NGAL probably expresses the degree of active damage underlying the chronic condition.
The current study included 30 children with chronic nephrotic syndrome their mean age (8.7±2.9 years), 18 males and 12 females and 15 apparently healthy children their mean age (7.5 ±3.6 years), 9 males and 6 females representing the control group.
All children are subjected to:
• Full history taking.
• Thorough physical examination.
• Abdominal ultrasonography
• Laboratory investigations including:
-Kidney function tests: urea, creatinine.
-Serum albumin.
-Serum Cholesterol.
-Electrolytes: Na, K.
-Serum protein electrophoresis.
-Estimated glomerular filtration rate
-Urine analysis
-Serum and urinary level of NGAL.
As regards to the SNGAL and UNGAL in this study, we found that SNGAL and UNGAL showed significantly higher concentration in NS group as compared with the control group.
In our study, we found that the SNGAL showed significantly higher concentration in SDNS group, SSNS group versus control group and SDNS group versus SSNS group.
In the present study, we found that UNGAL showed significantly higher concentration in SDNS group versus control group. While between SSNS group and control group, SDNS group and SSNS group, UNGAL showed higher concentration but it didn’t show statistical significance.
In the present study, we found that significantly higher concentration of both SNGAL and UNGAL in proteinuric group, non-proteinuric in comparison to the control group. While there was no statistical significance between Proteinuric versus non-Proteinuric group as regards SNGAL and UNGAL in spite of their higher concentration in proteinuric group.
In the present study, eGFR showed inverse correlation with SNGAL in NS patients and with SNGAL and UNGAL in SDNS group. Yet, it didn’t reach statistical significance.
In the present study, serum creatinine showed significantly positive correlation with SNGAL and with UNGAL in SDNS group. Yet, it didn’t reach statistical significance.
In our study, we found that SNGAL at a concentration of 56.1 ng/ml showed the best cutoff value where the sensitivity was 86.7% and the specifity was 90% calculated by the ROC curves.
While at a concentration of 3ng/ml, UNGAL had the best cutoff value where the sensitivity was 86.7% and the specificity was 80%.