scholarly journals Serum and Urine Neutrophil Gelatinase-Associated Lipocalin Levels Measured at Admission Predict Progression to Chronic Kidney Disease in Sepsis-Associated Acute Kidney Injury Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Pham Ngoc Huy Tuan ◽  
Dao Bui Quy Quyen ◽  
Huynh Van Khoa ◽  
Nguyen Duc Loc ◽  
Pham Van My ◽  
...  

Background. To evaluate the ratio of acute kidney injury (AKI) to chronic kidney disease (CKD) in sepsis-associated acute kidney injury (SA-AKI) patients of the intensive care unit (ICU) and predictive value of neutrophil gelatinase-associated lipocalin (NGAL) measured at the admission time in the progression of AKI to CKD. Methods. A study of 121 consecutive adult patients admitted to the intensive care unit (ICU) diagnosed as SA-AKI. AKI and CKD were defined based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Glomerular filtration rate (GFR) was calculated by the CKD-EPI formula. Serum and urine NGAL was measured using the BioVendor Human Lipocalin-2/NGAL ELISA with a blood sample taken at hospital admission time. Results. The ratio of AKI to CKD in SA-AKI patients was 22.3%. Mean concentration of serum and urine NGAL in AKI to the CKD group was 790.99 ng/ml and 885.72 ng/ml, higher significantly than those of recovery patients (351.86 ng/ml and 264.68 ng/ml), p<0.001. eGFR, both serum and urine NGAL had a predictive value for AKI to CKD (eGFR: AUC=0.857, Se=74.1%, Spe=92.6%, p<0.001. Serum NGAL: AUC=0.868, Se=77.8%, Spe=91.5%. Urine NGAL: AUC=0.869, Se=77.8%, Spe=92.6%, p<0.001. Conclusion. Serum and urine NGAL, measuring at hospital admission time, were good prognostic biomarkers of AKI to CKD in SA-AKI patients.

2019 ◽  
Vol 25 (10) ◽  
pp. 1122-1133
Author(s):  
Mustafa M. Sinna ◽  
Faris M.N. Altaf ◽  
Osama F. Mosa

Background: High global incidence of acute kidney injury (AKI) is an observable complication in critically ill patients. Long-term disease and medication complexity contribute to devastating chronic kidney disease (CKD), diminishing quality of life. Objective: To establish new biomarkers to guide patient care and facilitate novel therapeutics development. Methods: Serum and urinary levels of creatinine, CysC, and NGAL were estimated in 86 renal patients and compared with healthy controls for AKI and CKD categorization. Creatinine and CysC measurements were used to estimate GFR. Kidney biopsies were prepared for light microscopy for further characterization. Patients’ demographic data were used in group association studies. Results: Thirty-six patients met the criteria for AKI and 50 for CKD. Both mean serum and urine creatinine levels were significantly elevated by 2.8 and 2.6, respectively, from baseline in 48 h in the AKI group but not CKD group. Mean serum Cystatin C (CysC) values were higher than controls but similar in both disease states, while urine levels were slightly higher in CKD patients, and remained steady by the end of the follow-up (EF-Up). Further, a significant 2.9-fold and 5.5-fold (p=0.001) increase in serum NGAL in AKI and CKD, respectively, and a dramatic 7.1-factor reduction in AKI group, but no appreciable change in the CKD group from admission to EF-Up were observed. Similarly, urine NGAL level for AKI and CKD increased 3.2-fold and 6-fold respectively, on admission, which decreased moderately with the AKI group (2.5-fold) but increased by a factor of 1-8 (10.7- fold; p=0.001) at EF-Up. ROC assessment curve revealed relatively higher NGAL performance at good predictive values than CysC (p < 0.009). Conclusion: Our data demonstrated creatinine elevation by a factor > 2 in 48 h in AKI group but not CKD group, which returned close to normal levels by the EF-Up, an indication of abrupt renal injury in AKI, compared with a persistent effect in the CKD group. Both serum and urine NGAL sensitivity and specificity provided powerful discriminative tool between AKI and CKD by reduction in the AKI group and an increase in the CKD group by the EF-UP, thus, contributing in establishing the basis for AKI and CKD classification. CysC, however, displayed less sensitivity than NGAL, indicating effects by enigmatic non-specific factors.


2021 ◽  
pp. 189-190
Author(s):  
G.G. Kaushik ◽  
Shubham Maheshwari ◽  
Ankita Sharma

Introduction: Serum lipocalin 2 serve as a marker for kidney function. Lipocalin 2 is found in both CKD and kidney injury and it rises in acute kidney injury (AKI) and in patients have faster decline in kidney function. Aims And Objectives: To nd out correlation and assess of serum Neutrophil gelatinase-associated lipocalin 2 (NGAL 2) in patients with stages 2 to 4 of Chronic Kidney disease. The aim of the study was NGAL could represent a novel, sensitive marker of kidney function in adult patients with CKD. Material And Methods: Study involved 120 patients divided in Case group (60 patients) attended medical/ urology OPD or admitted in medical/urology ward of CKD2 – CKD4 while control group – age and sex matched healthy individuals/ stage I CKD patients was taken as control. The plasma/ serum were used for serum urea, creatinine, Cystatin C and lipocalin 2 under all aseptic precaution on receiving consent. Result:The patients of CKD included in study were having glomerulonephritis (46.7%), pyelonephritis (21.7%), diabetic kidney disease (13.3%), polycystic kidney disease (1.7%) and other causes (16.7%). CKD patients demonstrated elevated serum NGAL 159.14 ± 48.73 ng/ml, together with a rise in urea 59.9 ± 17.6 mg/dL, serum creatinine 1.56 ± 0.97 mg/dL and Cystatin C 199 ± 113 ng/ml as compared to control have serum NGAL 76.31 ± 26.34 ng/ml, urea 22.3 ± 5.7 mg/dL, serum creatinine 0.75 ± 0.14 mg/dL and Cystatin C 76 ± 17 ng/ml (P value <0.05). Conclusion: Serum NGAL closely correlates with serum Cystatin C, creatinine, and eGFR, and serve as a potential early and sensitive marker of impaired kidney function/ kidney injury.


2016 ◽  
Vol 33 (3) ◽  
pp. 133-139
Author(s):  
Azizun Nessa ◽  
Masud Ahmed ◽  
Md Amzad H Fakir ◽  
Mamun Mostafi

Acute kidney injury (AKI) usually detected by s. creatinine, which rises after 48 hrs of insult causes delay in diagnosis and to take preventive or therapeutic measures. Hence amongst many neutrophil gelatinase associated lipocalin (NGAL) is emerging as early, sensitive, and most promising biomarker of AKI both in urine and plasma. This prospective cross sectional observational study was carried out in Combined Military Hospital (CMH) Dhaka from October 2011 to March 2012. A total of willing 100 adult patients undergoing elective coronary angiogram (CAG) with normal kidney function were included in this study. Our study defined contrast induced AKI (CI-AKI) as rise of serum creatinine by >25% or e”0.5 mg/dl from baseline after exposure to contrast media and urine NGAL e”100 ng/ml was taken as cut off value to predict AKI as calculated by ROC curve. The main outcome measures were urine NGAL at 4 hrs and serum creatinine at 48 hrs after CAG. Significant elevation of urine NGAL was noted in 9 patients after 4 hrs of CAG, of them 8 (8%) patients developed raised s. creatinine (AKI) after 48 hrs. Patient demographics and procedural factors were although statistically significant in few instances but none was predictive of AKI.J Bangladesh Coll Phys Surg 2015; 33(3): 133-139


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