scholarly journals Differential Performance of Neutrophil Gelatinase-Associated Lipocalin and Cystatin C to Predict Ischemic Stroke

Author(s):  
Ling Peng ◽  
Xiaohong Chen ◽  
Yanhong Fu ◽  
Yuwei Yang ◽  
Jiafu Feng

Abstract Objective Both cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL) are markers of kidney injury and may also be marker candidates for neuroinflammation. The aim of this article is to explore the relationship between kidney injury and ischemic stroke (IS).Methods 498 IS patients were enrolled, and 173 IS-related disease control (DC) patients and 293 healthy control (HC) subjects were randomly selected. We analyzed the relationship between the levels of serum kidney function markers (including NGAL, Cre, Ure, CysC and eGFR) and the occurrence of IS.Results When they were admitted to the hospital, the NGAL level of patients with first-onset IS was higher than that of both HC group (z=5.964, P<0.001) and DC (z=12.191, P<0.001); The level of CysC of them was higher than that of HC group (z=5.762, P<0.001), and was the similar with that of DC group (z=1.663, P=0.289). The partial correlation coefficient between NGAL and the occurrence of IS was the highest (rp=0.341, P<0.001) in IS patients with normal kidney function. However, the partial correlation coefficient between CysC and IS was the highest (rp=0.460) , P<0.001) in IS patients with chronic kidney disease (CKD). For patients with normal kidney function, only NGAL was a risk factor for IS [OR(95%CI)=6.54(3.75,11.41)], and had the certain predictive performance AUC=0.734(z=12.928, P<0.001). However, for CKD patients, CysC has better predictive performance for IS occurrence AUC=0.835 (z=11.343, P<0.001) and risk assessment ability [OR(95%CI)=5.97(2.45, 14.56)] than NGAL.Conclusion IS is related to kidney injury and neuroinflammation. NGAL and CysC are suitable for IS prediction in patients with normal kidney function and CKD, respectively. Researchers should pay attention to the changes of NGAL and CysC for the prevention and treatment of stroke in these two types of patients, respectively.

2019 ◽  
Vol 15 (2) ◽  
pp. 120
Author(s):  
Rosita Kai ◽  
Bachtiar Murtala ◽  
Andi Alfian Zainuddin ◽  
Muzakkir Amin ◽  
Muhammad Ilyas

Increased serum calcium and phosphate associated with cardiovascular disease in patients with chronic kidney disease, but research on the relationship between coronary artery calcium scores with serum calcium and phosphate in individuals with normal kidney function is lacking. We explore the relationship of serum calcium and phosphate levels with coronary atherosclerosis as assessed by cardiac Multislice Computed Tomography (MSCT) in individuals with normal kidney function. This study aims to assess the correlation of calcium level scores on cardiac MSCT examination with serum calcium and phosphate levels, and assess the association with risk factors for coronary heart disease. This study was a cross-sectional study of 40 subjects who underwent cardiac MSCT examination with normal kidney function, at RSUP Dr. Wahidin Sudirohusodo Makassar during the March-July 2019 period. The results showed an correlation between coronary artery calcium scores with calcium and serum phosphate (serum calcium r = 0.67, serum phosphate r = 0.53, p <0.05).


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.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Linda Awdishu ◽  
Shirley Tsunoda ◽  
Michelle Pearlman ◽  
Chanthel Kokoy-Mondragon ◽  
Majid Ghassemian ◽  
...  

Background. Acute kidney injury (AKI) is a frequent complication of decompensated cirrhosis with increased mortality. Traditional biomarkers such as serum creatinine are not sensitive for detecting injury without functional change. We hypothesize that urinary exosomes potentially carry markers that differentiate the type of kidney injury in cirrhotic patients. Methods. This is a prospective, single-center, and observational study of adult patients with cirrhosis. The patient groups included healthy normal controls, compensated cirrhosis with normal kidney function, decompensated cirrhosis with normal kidney function, and decompensated cirrhosis with AKI. Data were extracted from the electronic health record including etiology of liver disease, MELD score, history of decompensation, Child-Turcotte-Pugh score, history of AKI, and medication exposures. Urine samples were collected at the time of consent. Urine exosome protein content was analyzed, and proteomic data were validated by immunoblotting. Statistical analysis included partial least squares-discriminant analysis coupled with variable importance in projection identification. Results. Eighteen cirrhotic subjects were enrolled, and six healthy control subjects were extracted from our biorepository. Urine exosomes were isolated, and 1572 proteins were identified. Maltase-glucoamylase was the top discriminating protein confirmed by western blotting. Conclusions. Patients with cirrhosis and AKI have upregulation of renal brush border disaccharidase, MGAM, in urinary exosomes which may differentiate the type of kidney injury in cirrhosis; however, the clinical significance of this requires further validation.


2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Max Bell ◽  
Anders Larsson ◽  
Per Venge ◽  
Rinaldo Bellomo ◽  
Johan Mårtensson

Purpose. To assess urinary tissue inhibitor of metalloproteinases-2 and insulin-like growth factor binding protein 7 ([TIMP-2]·[IGFBP7]), urinary neutrophil gelatinase-associated lipocalin (NGAL), and urinary cystatin-C as acute kidney injury predictors (AKI) exploring the association of nonrenal factors with elevated biomarker levels.Methods. We studied 94 patients with urine collected within 48 hours of ICU admission and no AKI at sampling. AKI was defined by the Kidney Disease: Improving Global Outcomes criteria. Predictive performance was assessed by the area under the receiver operating characteristics (ROC) curve. Associations between biomarkers and clinical factors were assessed by multivariate linear regression.Results. Overall, 19 patients (20%) developed AKI within 48 hours. [TIMP-2]·[IGFBP7], NGAL, or cystatin-C admission levels did not differ between patients without AKI and patients developing AKI. [TIMP-2]·[IGFBP7], NGAL, and cystatin-C were poor AKI predictors (ROC areas 0.34–0.51). Diabetes was independently associated with higher [TIMP-2]·[IGFBP7] levels (P=0.02) but AKI was not (P=0.24). Sepsis was independently associated with higher NGAL (P<0.001) and cystatin-C (P=0.003) levels.Conclusions. Urinary [TIMP-2]·[IGFBP7], NGAL, and cystatin-C should be used cautiously as AKI predictors in general ICU patients since urine levels of these biomarkers are affected by factors other than AKI and their performance can be poor.


2020 ◽  
Vol 4 (2) ◽  
pp. 979-985
Author(s):  
E.Yu. Brankovskaya ◽  
◽  
L.V. Kartun ◽  
E.V. Hodosovskaya ◽  
N.P. Mitkovskaya ◽  
...  

The aim of the study was to investigate specific clinical manifestations, homeostasis indices and parameters of the cardiovascular system in patients with acute ST-elevation myocardial infarction (STEMI) and acute ischemic kidney injury. Methods. 173 patients with STEMI participated in the study. The study group consisted of 111 patients with acute ischemic kidney injury associated with myocardial infarction (MI); 62 patients with MI and normal kidney function were enrolled in the comparison group. Clinical, anthropometric, laboratory, and instrumental diagnostic methods were used. Results. Compared with patients of the MI and normal kidney function group, those with MI and acute ischemic kidney injury had a higher average heart rate, required more prolonged vasopressor and/or inotropic therapy, and more frequently developed tachyarrhythmias with adverse prognostic impact and postinfarction aneurysms. The study revealed that patients of the MI and acute ischemic kidney injury group demonstrated more severe dilatation of the left ventricle (LV), more pronounced reduction in myocardial LV contractility according to echocardiography results; they developed multivessel coronary artery disease more frequently. Furthermore, patients of this group had a higher incidence of infarction-associated artery damage located in the proximal segments of major coronary arteries and more frequently developed thrombotic occlusion in the infarction-affected artery. Patients with MI and acute ischemic kidney injury had higher levels of inflammatory, myocardial necrosis, hemostasis and neurohormonal activation markers. Higher concentration of neutrophil gelatinase-associated lipocalin (uNGAL) was observed in patients with MI and acute ischemic kidney injury; moreover, in 14,1% of patients belonging to this group, elevated levels of this marker preceded the diagnostically significant increase in creatinine concentration and decrease in glomerular filtration rate. Conclusion. In patients with MI, the development of acute ischemic kidney injury was accompanied by more severe clinical manifestations, prognostically adverse indicators of early LV remodeling and coronary arteries disease, enhanced inflammatory processes and neuroendocrine system activity, as well as by elevated levels of myocardial necrosis and blood coagulation activity markers. The present study suggests applying uNGAL as an early marker of acute ischemic kidney injury in patients with MI.


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