Predicting Acute Renal Injury in Cancer Patients Receiving Cisplatin Using Urinary Neutrophil Gelatinase-Associated Lipocalin and Cystatin C

Background Acute renal dysfunction (ARD) and subsequent acute renal failure after cardiac surgery are associated with high mortality and morbidity. Early therapeutic or preventive intervention is hampered by the lack of an early biomarker for acute renal injury. Recent studies showed that urinary neutrophil gelatinase-associated lipocalin (NGAL or lipocalin 2) is up-regulated early (within 1-3 h) after murine renal injury and in pediatric ARD after cardiac surgery. The authors hypothesized that postoperative urinary NGAL concentrations are increased in adult patients developing ARD after cardiac surgery compared with patients without ARD. Methods After institutional review board approval, 81 cardiac surgical patients were prospectively studied. Urine samples were collected immediately before incision and at various time intervals after surgery for NGAL analysis by quantitative immunoblotting. ARD was defined as peak postoperative serum creatinine increase by 50% or greater compared with preoperative serum creatinine. Results Sixteen of 81 patients (20%) developed postoperative ARD, and the mean urinary NGAL concentrations in patients who developed ARD were significantly higher early after surgery (after 1 h: 4,195 +/- 6,520 [mean +/- SD] vs. 1,068 +/- 2,129 ng/ml; P < 0.01) compared with patients who did not develop ARD. Mean urinary NGAL concentrations continued to increase and remained significantly higher at 3 and 18 h after cardiac surgery in patients with ARD. In contrast, urinary NGAL in patients without ARD decreased rapidly after cardiac surgery. Conclusions Patients developing postoperative ARD had significantly higher urinary NGAL concentrations early after cardiac surgery. Urinary NGAL may therefore be a useful early biomarker of ARD after cardiac surgery. These findings may facilitate the early detection of acute renal injury and potentially prevent progression to acute renal failure.

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Increase of Neutrophil gelatinase-associated Lipocalin and Cystatin C after cardiac surgery – new options for detecting acute kidney injury

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0031-1297556 ◽

2012 ◽

Vol 60 (S 01) ◽

Author(s):

H Baumgarten ◽

C Liebetrau ◽

A Van Linden ◽

B Njezic ◽

T Walther ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Cystatin C ◽

Kidney Injury ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

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

European Journal of Pediatrics ◽

10.1007/s00431-021-04019-w ◽

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.

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Changes in Urinary and Serum Levels of Novel Biomarkers after Administration of Gadolinium-based Contrast Agents

Biomarker Insights ◽

10.4137/bmi.s39199 ◽

2016 ◽

Vol 11 ◽

pp. BMI.S39199 ◽

Cited By ~ 3

Author(s):

Habib Mawad ◽

Louis-Philippe Laurin ◽

Jean-François Naud ◽

François A. Leblond ◽

Nathalie Henley ◽

...

Keyword(s):

Renal Function ◽

Contrast Agents ◽

Cystatin C ◽

Normal Renal Function ◽

Serum Levels ◽

Serum Cystatin C ◽

Baseline Serum ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Novel Biomarkers ◽

Neutrophil Gelatinase

Objective The aim of our study is to describe the changes in urinary and serum levels of novel biomarkers after gadolinium contrast administration in patients with normal renal function. Methods We measured four biomarkers in 28 volunteers: interleukin-18 (IL-18), N-acetyl-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin, and cystatin C. Urinary and serum samples were collected at 0, 3, and 24 hours following gadolinium administration. Results Baseline serum creatinine was 57.8 ± 34.5 μmol/L and remained stable. Urinary IL-18 levels increased significantly at three hours (10.7 vs. 7.3 ng/mg creatinine; P < 0.05). Similarly, urinary NAG levels increased significantly at three hours (3.9 vs. 2.2 IU/mg creatinine; P < 0.001). For both these markers, the difference was no longer significant at 24 hours. No statistically significant differences were observed for urinary and serum neutrophil gelatinase-associated lipocalin levels and for serum cystatin C levels. Conclusions Urinary IL-18 and NAG levels increased transiently after administration of gadolinium-based contrast agents in patients with normal renal function.

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Μελέτη μοριακών δεικτών της οξείας νεφρικής βλάβης στο πλάσμα και στα ούρα κατά την εξωσωματική λιθοθρυψία

10.12681/eadd/34926 ◽

2014 ◽

Author(s):

Ιωάννης Καρδάκος

Keyword(s):

Cystatin C ◽

Interleukin 18 ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

Η λιθίαση αποτελεί την πιο συχνή πάθηση του ουροποιητικού συστήματος και ένα από τα συνηθέστερα επείγοντα ουρολογικά συμβάματα, ενώ διατηρεί μία ευρεία αιτιολογική βάση παθογένειας, επηρεαζόμενη από γενετικά καθορισμένους παράγοντας, όπως και από πλήθος δημογραφικών και περιβαλλοντικών μεταβλητών. Η αντιμετώπιση της λιθίασης τα τελευταία χρόνια πλαισιώνεται από επαναστατικές τεχνολογικές αλλαγές, καθώς πλέον λιγότερο από 5% των περιπτώσεων λιθίασης αντιμετωπίζεται με την παραδοσιακή ανοιχτή χειρουργική μέθοδο. Έτσι, η μέθοδος της εξωσωματικής λιθοτριψίας με την παραγωγή κυμάτων κρούσης εφαρμόζεται ευρέως, παρουσιάζοντας εξαιρετική αποτελεσματικότητα, αν και σε ορισμένες περιπτώσεις ενδέχεται να προκαλέσει νεφρική βλάβη. Τα τελευταία χρόνια, η εξέταση μοριακών δεικτών της οξείας νεφρικής βλάβης μετά την εφαρμογή της εξωσωματικής λιθοθρυψίας είναι εξαιρετικά δημοφιλής, με σκοπό την έγκαιρη διάγνωση και αποτελεσματική αντιμετώπισή της. Σκοπός της παρούσας διδακτορικής διατριβής είναι η εξέταση των μοριακών δεικτών Plasma neutrophil Gelatinase-Associated Lipocalin (NGAL) στο πλάσμα και στα ούρα, cystatin C στο πλάσμα και Interleukin -18 (IL-18) στα ούρα, καθώς οι δείκτες αυτοί έχουν ανεβρεθεί αυξημένοι σε καταστάσεις οξείας νεφρικής βλάβης, έχοντας τη δυνατότητα να αναδείξουν τον βαθμό της νεφρικής βλάβης μετά την εξωσωματική λιθοθρυψία. Σύμφωνα με τα αποτελέσματα αν και οι εξεταζόμενοι μοριακοί δείκτες φαίνεται πως αποτελούν σημαντικούς δείκτες για την αποτελεσματικότητα της εξωσωματικής λιθοθρυψίας και την ιστική κατάσταση του νεφρού μετά την εφαρμογή αυτής της μη επεμβατικής μεθόδου, παρόλα αυτά οι μη στατιστικές διαφορές που επισημάνθηκαν ανάμεσα στα διάφορα ζεύγη των μετρήσεων πριν και μετά την εφαρμογή της μεθόδου καταδεικνύουν πως δεν είναι επαρκείς για την ανάδειξη νεφρικής βλάβης, και για το λόγο αυτό χρήζουν περαιτέρω διερεύνησης. Λέξεις κλειδιά: NGAL, Cystatin C, Interleukin 18, εξωσωματική λιθοτριψία

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