scholarly journals The Use of Plasma and Urine Neutrophil Gelatinase Associated Lipocalin (NGAL) and Cystatin C in Early Diagnosis of Septic Acute Kidney Injury in Critically Ill Patients

2013 ◽  
Vol 34 (4) ◽  
pp. 237-246 ◽  
Author(s):  
Müge Aydoğdu ◽  
Gül Gürsel ◽  
Banu Sancak ◽  
Serpil Yeni ◽  
Gülçin Sarı ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Urinary Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Septic Acute Kidney Injury ◽  
Neutrophil Gelatinase

Aim: To assess and compare the roles of plasma and urine concentrations of neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C for early diagnosis of septic acute kidney injury (AKI) in adult critically ill patients.Methods: Patients were divided into three groups as sepsis-non AKI, sepsis-AKI and non sepsis-non AKI. Plasma samples for NGAL and Cystatin C were determined on admission and on alternate days and urinary samples were collected for every day until ICU discharge.Results: One hundred fifty one patients were studied; 66 in sepsis-non AKI, 63 in sepsis-AKI, 22 in non-sepsis-non-AKI groups. Although plasma NGAL performed less well (AUC 0.44), urinary NGAL showed significant discrimination for AKI diagnosis (AUC 0.80) with a threshold value of 29.5 ng/ml (88% sensitivity, 73% specificity). Both plasma and urine Cystatin C worked well for the diagnosis of AKI (AUC 0.82 and 0.86, thresholds 1.5 and 0.106 mg/L respectively).Conclusion: Plasma and urinary Cystatin C and urinary NGAL are useful markers in predicting AKI in septic critically ill patients. Plasma NGAL raises in patients with sepsis in the absence of AKI and should be used with caution as a marker of AKI in septic ICU patients.

scholarly journals Plasma Neutrophil Gelatinase Associated Lipocalin (NGAL) – Early Biomarker for Acute Kidney Injury in Critically Ill Patients

2015 ◽  
Vol 1 (4) ◽  
pp. 154-161 ◽  
Author(s):  
Grigorescu Bianca ◽  
Fodor Raluca ◽  
Mihaly Veres ◽  
Monica Orlandea ◽  
Judita Badea ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Creatinine Clearance ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Likelihood Ratios ◽  
Roc Curve Analysis ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Abstract Introduction: NGAL (Neutrophil Gelatinase Associated Lipocalin) is a biomarker recently introduced into clinical practice for the early diagnosis of acute kidney injury (AKI). The aim of this study was to correlate the plasmatic NGAL value determined at admission with clinical progression and severity of AKI in critically ill patients. Material and method: Thirty two consecutive critically ill adult patients at risk of developing AKI (trauma, sepsis), admitted in Intensive Care Unit of the Clinical County Emergency Hospital Mures, between January to March 2015 were enrolled in the study. For each patient included in the study plasma NGAL levels were determined on admission, and these were correlated with the degree of AKI development (according to AKIN criteria) at 48 hours and 5 days post admission. The discriminatory power of NGAL, creatinine, creatinine clearance and corrected creatinine (depending on water balance) were determined using the ROC (receiver-operating characteristic) and likelihood ratios. Results: ROC curve analysis showed a better discriminatory capacity in terms of early diagnosis of AKI for NGAL (AUC=0.81 for NGAL, AUC=0.59 for creatinine, AUC=0.62 for corrected creatinine, AUC=0.29 for creatinine clearance). The value of likelihood ratio was also significantly higher for NGAL (3.01±2.73 for NGAL, 1.27±1.14 for creatinine, 1.78±1.81 for corrected creatinine, and 0.48±0.33 for creatinine clearance). Conclusions: NGAL biomarker has a better discrimination capacity for early prediction of acute kidney injury compared to previously used markers.

scholarly journals Systemic and Urinary Neutrophil Gelatinase-Associated Lipocalins Are Poor Predictors of Acute Kidney Injury in Unselected Critically Ill Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Annick A. Royakkers ◽  
Catherine S. Bouman ◽  
Pauline M. Stassen ◽  
Joke C. Korevaar ◽  
Jan M. Binnekade ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Secondary Analysis ◽  
Kidney Injury ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Observational Cohort ◽  
Neutrophil Gelatinase

Background. Neutrophil gelatinase-associated lipocalin (NGAL) in serum and urine have been suggested as potential early predictive biological markers of acute kidney injury (AKI) in selected critically ill patients.Methods. We performed a secondary analysis of a multicenter prospective observational cohort study of unselected critically ill patients.Results. The analysis included 140 patients, including 57 patients who did not develop AKI, 31 patients who developed AKI, and 52 patients with AKI on admission to the ICU. Levels of sNGAL and uNGAL on non-AKI days were significantly lower compared to levels of sNGAL on RIFLERISKdays, RIFLEINJURYdays, and RIFLEFAILUREdays. The AUC of sNGAL for predicting AKI was low: 0.45 (95% confidence interval (CI) 0.27–0.63) and 0.53 (CI 0.38–0.67), 2 days and 1 day before development of AKI, respectively. The AUC of uNGAL for predicting AKI was also low: 0.48 (CI 0.33–0.62) and 0.48 (CI 0.33–0.62), 2 days and 1 day before development of AKI, respectively. AUC of sNGAL and uNGAL for the prediction of renal replacement therapy requirement was 0.47 (CI 0.37–0.58) and 0.26 (CI 0.03–0.50).Conclusions. In unselected critically ill patients, sNGAL and uNGAL are poor predictors of AKI or RRT.

scholarly journals Comparison of Neutrophil Gelatinase-associated Lipocalin and Renal Resistive Index as Acute Kidney Injury Predictor in Critically Ill Patients at ICU H. Adam Malik Hospital Medan

2021 ◽  
Vol 9 (B) ◽  
pp. 1637-1639
Author(s):  
Muhammad Aldi Rivai Ginting ◽  
Achsanuddin Hanafie ◽  
Bastian Lubis
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index ◽  
Ngal Level ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

BACKGROUND: Acute kidney injury (AKI) is a complication found in critically ill patients. Current consensus explains that diagnosis of AKI based on increased serum creatinine and decreased urine output. Neutrophil gelatinase-associated lipocalin (NGAL) level is increased a few hours after tubular damage occurred and can predict AKI more significantly than serum creatinine. Renal resistive index (RRI) is also a good marker in predicting the early stage of AKI. AIM: This study aimed to compare RRI and NGAL level as marker to predict incidence of AKI in critically ill patients treated in the Intensive Care Unit (ICU) at H. Adam Malik Hospital Medan. METHODS: This was an observational prospective cohort study and conducted in ICU at H. Adam Malik Hospital Medan in April-May 2021. This study had been approved by the Ethics Committee of Faculty of Medicine, Sumatera Utara University and H. Adam Malik Hospital Medan. Inclusion criteria are critical patients aged 18–65 years with 1st and 2nd priority level. Consecutive sampling was used. Resistive Index (RI) measured using USG Doppler by researcher and the results confirmed by ICU supervisors, while urine NGAL level measured within 3 h after ICU admission. Plasma urea and creatinine level measured after 24h after ICU admission. RESULTS: A total of 40 samples were collected; percentage of men and women are 66–35%, respectively (p = 0.001). There was a significant difference RI between AKI-group and non-AKI group (0.719 ± 0.060 and 0.060 ± 0.077, respectively) (p = 0.001). RI has a sensitivity of 71%, specificity of 84%, and accuracy of 87% in predicting occurrence of AKI with AUROC = 0.873. Meanwhile, NGAL has a sensitivity, specificity, and accuracy (66%, 89%, 78%, respectively) in early prediction of AKI incidence in critically ill patients. CONCLUSION: RI value was higher in AKI group than non-AKI group. RRI has better sensitivity than NGAL in predicting incidence of AKI.

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