Clinical Application Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 as Indicators of Inflammation Persistence and Acute Kidney Injury in Children with Urinary Tract Infection

Background. The aim of this study was to examine the novel renal biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) to assist pediatricians in the assessment of longer duration of inflammation and acute kidney injury (AKI) development during urinary tract infection (UTI).Methods. The patients enrolled in the study comprised 50 children (mean age was 6 months) with UTI. NGAL in serum and urine (sNGAL and uNGAL, resp.) and KIM-1 in urine were measured by enzyme-linked immunosorbent assays.Results. uNGAL levels in subjects with longer duration of inflammation were higher (115.37 ng/mL) than uNGAL levels in subjects with shorter duration of inflammation (67.87 ng/mL,P=0.022). Difference in sNGAL and KIM-1 levels was not significant (P=0.155andP=0.198, resp.). Significant difference was seen in KIM-1 excretion among groups with and without AKI (P=0.038). KIM-1 was not able to discriminate between subjects with and without AKI (area under the curves (AUC) = 0.620,P=0.175).Conclusions. uNGAL cannot be used for screening of the duration of inflammation during UTI. Accuracy of KIM-1 in screening of AKI development in children with UTI is low. We suggest larger studies to check the negative predictive value of KIM-1 for the development of AKI.

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Urinary neutrophil gelatinase-associated lipocalin for early detection of acute kidney injury in geriatric patients with urinary tract infection treated by colistin

Clinical Nephrology ◽

10.5414/cn107974 ◽

2013 ◽

Vol 80 (12) ◽

pp. 405-416 ◽

Cited By ~ 10

Author(s):

Linda Shavit ◽

Rackhel Manilov ◽

Yonit Wiener-Well ◽

Nurit Algur ◽

Itzchak Slotki

Keyword(s):

Acute Kidney Injury ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Early Detection ◽

Geriatric Patients ◽

Kidney Injury ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

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Diagnostic accuracy of urine neutrophil gelatinase-associated lipocalin and urine kidney injury molecule-1 as predictors of acute pyelonephritis in young children with febrile urinary tract infection

Central European Journal of Immunology ◽

10.5114/ceji.2019.87069 ◽

2019 ◽

Vol 44 (2) ◽

pp. 174-180 ◽

Cited By ~ 1

Author(s):

Grażyna Krzemień ◽

Małgorzata Pańczyk-Tomaszewska ◽

Iwona Kotuła ◽

Urszula Demkow ◽

Agnieszka Szmigielska

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Diagnostic Accuracy ◽

Acute Pyelonephritis ◽

Kidney Injury ◽

Febrile Urinary Tract Infection ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Kidney Injury Molecule 1 ◽

Neutrophil Gelatinase

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Neutrophil Gelatinase Associated Lipocalin (NGAL), an Early Marker for Urinary Tract Infection and Acute Kidney Injury

Asian Journal of Biochemistry ◽

10.3923/ajb.2018.15.21 ◽

2017 ◽

Vol 13 (1) ◽

pp. 15-21 ◽

Cited By ~ 1

Author(s):

U. Munilakshm ◽

K.N. Shashidhar ◽

C. Muninaraya ◽

Madhavi Reddy ◽

V. Lakshmaiah

Keyword(s):

Acute Kidney Injury ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Kidney Injury ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Early Marker ◽

Neutrophil Gelatinase

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Evaluation of urinary neutrophil gelatinase-associated lipocalin and urinary kidney injury molecule-1 as biomarkers of renal function in cancer patients treated with cisplatin

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220901756 ◽

2020 ◽

Vol 26 (7) ◽

pp. 1643-1649

Author(s):

Elliyeh Ghadrdan ◽

Sholeh Ebrahimpour ◽

Sanambar Sadighi ◽

Samira Chaibakhsh ◽

Zahra Jahangard-Rafsanjani

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Characteristic Curve ◽

Kidney Injury ◽

Acute Kidney Injury Network ◽

The Novel ◽

Urinary Ngal ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Kidney Injury Molecule 1 ◽

Neutrophil Gelatinase

Introduction Cisplatin-associated acute kidney injury (AKI) is the major limitation to the use of cisplatin-based chemotherapy regimens. Serum creatinine as a traditional marker did not increase in a timely enough fashion in AKI patients. Therefore, recently, the novel markers such as neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were considered for early detection of AKI. The aim of this study was to compare the sensitivity and specificity of urinary NGAL and KIM-1 with serum creatinine in cisplatin related AKI. Methods Patients ≥18 years with solid tumors who received cisplatin-based chemotherapy were included. Urine samples were collected 0, 6 and 24 h after cisplatin infusion and the urinary NGAL, KIM-1, and creatinine concentrations were evaluated. NGAL and KIM-1 concentrations were adjusted based on urine creatinine to eliminate hydration effects. Serum creatinine levels were assessed at the base and 72 h after cisplatin administration. Results Seven out of the 35 recruited patients (20%) suffered from AKI defined by Acute Kidney Injury Network criteria. In AKI patients, the ratio of urinary KIM-1–creatinine at 24 h compared to baseline (24 h/baseline) and NGAL–creatinine 24 h/baseline were significantly higher than those of non-AKI group ( p = 0.037 and 0.047 respectively). The area under the receiver-operating characteristic curve for KIM-1–creatinine 24 h/baseline and NGAL–creatinine 24 h/baseline were 0.78 (0.59–0.96, p = 0.032) and 0.77 (0.57–0.97, p = 0.036) respectively. Conclusions Our findings showed that the changes in urinary NGAL–creatinine and KIM-1–creatinine ratios, 24 h after cisplatin administration can be utilized to predict AKI in cisplatin recipients.

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The role of frailty in geriatric cranial neurosurgery for primary central nervous system neoplasms

Neurosurgical FOCUS ◽

10.3171/2020.7.focus20426 ◽

2020 ◽

Vol 49 (4) ◽

pp. E15

Author(s):

Shane Shahrestani ◽

Brandon M. Lehrich ◽

Ali R. Tafreshi ◽

Nolan J. Brown ◽

Brian V. Lien ◽

...

Keyword(s):

Acute Kidney Injury ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Geriatric Patients ◽

Kidney Injury ◽

Csf Leak ◽

Significant Difference ◽

Cns Neoplasm

OBJECTIVEFrailty is a clinical state of increased vulnerability due to age-associated decline and has been well established as a perioperative risk factor. Geriatric patients have a higher risk of frailty, higher incidence of brain cancer, and increased postoperative complication rates compared to nongeriatric patients. Yet, literature describing the effects of frailty on short- and long-term complications in geriatric patients is limited. In this study, the authors evaluate the effects of frailty in geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm.METHODSThe authors conducted a retrospective cohort study of geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm between 2010 and 2017 by using the Nationwide Readmission Database. Demographics and frailty were queried at primary admission, and readmissions were analyzed at 30-, 90-, and 180-day intervals. Complications of interest included infection, anemia, infarction, kidney injury, CSF leak, urinary tract infection, and mortality. Nearest-neighbor propensity score matching for demographics was implemented to identify nonfrail control patients with similar diagnoses and procedures. The analysis used Welch two-sample t-tests for continuous variables and chi-square test with odds ratios.RESULTSA total of 6713 frail patients and 6629 nonfrail patients were identified at primary admission. At primary admission, frail geriatric patients undergoing cranial neurosurgery had increased odds of developing acute posthemorrhagic anemia (OR 1.56, 95% CI 1.23–1.98; p = 0.00020); acute infection (OR 3.16, 95% CI 1.70–6.36; p = 0.00022); acute kidney injury (OR 1.32, 95% CI 1.07–1.62; p = 0.0088); urinary tract infection prior to discharge (OR 1.97, 95% CI 1.71–2.29; p < 0.0001); acute postoperative cerebral infarction (OR 1.57, 95% CI 1.17–2.11; p = 0.0026); and mortality (OR 1.64, 95% CI 1.22–2.24; p = 0.0012) compared to nonfrail geriatric patients receiving the same procedure. In addition, frail patients had a significantly increased inpatient length of stay (p < 0.0001) and all-payer hospital cost (p < 0.0001) compared to nonfrail patients at the time of primary admission. However, no significant difference was found between frail and nonfrail patients with regard to rates of infection, thromboembolism, CSF leak, dural tear, cerebral infarction, acute kidney injury, and mortality at all readmission time points.CONCLUSIONSFrailty may significantly increase the risks of short-term acute complications in geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm. Long-term analysis revealed no significant difference in complications between frail and nonfrail patients. Further research is warranted to understand the effects and timeline of frailty in geriatric patients.

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