scholarly journals Serum NGAL, BNP, PTH, and albumin do not improve glomerular filtration rate estimating formulas in children

2021 ◽  
Author(s):  
Julie Mouron-Hryciuk ◽  
François Cachat ◽  
Paloma Parvex ◽  
Thomas Perneger ◽  
Hassib Chehade
Keyword(s):  
Glomerular Filtration Rate ◽  
Parathyroid Hormone ◽  
Serum Creatinine ◽  
Brain Natriuretic Peptide ◽  
Glomerular Filtration ◽  
Natriuretic Peptide ◽  
Cystatin C ◽  
Filtration Rate ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

AbstractGlomerular filtration rate (GFR) is difficult to measure, and estimating formulas are notorious for lacking precision. This study aims to assess if the inclusion of additional biomarkers improves the performance of eGFR formulas. A hundred and sixteen children with renal diseases were enrolled. Data for age, weight, height, inulin clearance (iGFR), serum creatinine, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), parathyroid hormone (PTH), albumin, and brain natriuretic peptide (BNP) were collected. These variables were added to the revised and combined (serum creatinine and cystatin C) Schwartz formulas, and the quadratic and combined quadratic formulas. We calculated the adjusted r-square (r2) in relation to iGFR and tested the improvement in variance explained by means of the likelihood ratio test. The combined Schwartz and the combined quadratic formulas yielded best results with an r2 of 0.676 and 0.730, respectively. The addition of BNP and PTH to the combined Schwartz and quadratic formulas improved the variance slightly. NGAL and albumin failed to improve the prediction of GFR further. These study results also confirm that the addition of cystatin C improves the performance of estimating GFR formulas, in particular the Schwartz formula.Conclusion: The addition of serum NGAL, BNP, PTH, and albumin to the combined Schwartz and quadratic formulas for estimating GFR did not improve GFR prediction in our population. What is Known:• Estimating glomerular filtration rate (GFR) formulas include serum creatinine and/or cystatin C but lack precision when compared to measured GFR.• The serum concentrations of some biological parameters such as neutrophil gelatinase-associated lipocalin (NGAL), parathyroid hormone (PTH), albumin, and brain natriuretic peptide (BNP) vary with the level of renal function. What is New:• The addition of BNP and PTH to the combined quadratic formula improved its performance only slightly. NGAL and albumin failed to improve the prediction of GFR further.

Abstract 14905: Combined Assessment of Serum Neutrophil Gelatinase-Associated Lipocalin and N-Terminal Pro-B-Type Natriuretic Peptide Levels on Admission Improves the Prediction of Mortality in Patients Hospitalized to Coronary Care Units

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ryunosuke Okuyama ◽  
Junnichi Ishii ◽  
Hideki Kawai ◽  
Takashi Muramatsu ◽  
Hiroyuki Naruse ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Natriuretic Peptide ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Left Ventricular Ejection ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Coronary Care ◽  
Neutrophil Gelatinase ◽  
Coronary Care Units

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is best known clinically as a novel and early marker of acute kidney injury. Renal dysfunction portends significant risk in patients admitted to coronary care units (CCUs). Thus, a sensitive marker of renal injury might also help to risk stratify patients hospitalized to CCUs. We prospectively investigated the prognostic value of a combination of serum NGAL and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels on admission for mortality in patients hospitalized to CCUs. Methods: We measured serum NGAL and NT-proBNP levels on admission in 974 consecutive patients hospitalized to CCUs. Among these patients, heart failure was present in 55%, and acute coronary syndrome in 40%. Results: Serum NGAL levels significantly correlated with NT-proBNP levels (r = 0.37, p <0.0001) and estimated glomerular filtration rate (r = -0.68, p < 0.0001). During a mean follow-up period of 829 days after admission, there were 178 (18%) all-cause deaths including 145 cardiovascular deaths. Comparably, patients who died were older (median, 78 vs. 72 yrs, p < 0.0001), had higher levels of NGAL (102 vs. 55 ng/ml, p < 0.0001), NT-proBNP (4043 vs. 1250 pg/ml, p < 0.0001), D-dimer (2.6 vs. 1.1 μg/ml, p < 0.0001), and high-sensitive C-reactive protein (6.0 vs.2.0 mg/l, p < 0.0001), and displayed lower values of left ventricular ejection fraction (39 vs. 50 %, p < 0.0001) and estimated glomerular filtration rate (43 vs. 65 ml/min/1.73m 2 , p < 0.0001) than those who did not. In multivariate Cox regression analysis including 11 clinical and biochemical variables, tertiles of NGAL (p = 0.02) and NT-proBNP (p = 0.02) was independently associated with all-cause deaths. The combination of NGAL and NT-proBNP tertiles were associated with increased all-cause mortality rates ( Figure ). Conclusion: The combined assessment of NGAL and NT-proBNP levels on admission may be useful for evaluating the risk of mortality in patients admitted to CCUs.

Sign in / Sign up

Export Citation Format

Share Document