Early Diagnosis in Acute Kidney Failure: Neutrophil Gelatinase Associated Lipocain (NGAL), Kidney Injury Molecule-1 (KIM-1), Interleukine-18 (IL-18), Cystatin C

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.

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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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Poor Glycemic Control Can Increase the Plasma Kidney Injury Molecule-1 Concentration in Normoalbuminuric Children and Adolescents with Diabetes Mellitus

Children ◽

10.3390/children8050417 ◽

2021 ◽

Vol 8 (5) ◽

pp. 417

Author(s):

Moon Bae Ahn ◽

Kyoung Soon Cho ◽

Seul Ki Kim ◽

Shin Hee Kim ◽

Won Kyoung Cho ◽

...

Keyword(s):

Glycosylated Hemoglobin ◽

Significant Risk ◽

Area Under The Curve ◽

Kidney Injury ◽

Significant Risk Factor ◽

Controlled Study ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Diabetic Children ◽

Kidney Injury Molecule 1 ◽

Neutrophil Gelatinase

Diabetic nephropathy (DN) is a serious microvascular complication in childhood diabetes and microalbuminuria has been a solid indicator in the assessment of DN. Nevertheless, renal injury may still occur in the presence of normoalbuminuria (NA) and various tubular injury biomarkers have been proposed to assess such damage. This case-controlled study aimed to evaluate plasma and urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 (KIM-1) levels in diabetic children particularly in those with normo- and high-NA stages and determine their role in predicting DN. Fifty-four children/adolescents with type 1 and 2 diabetes and forty-four controls aged 7–18 years were included. The baseline clinical and laboratory characteristics including plasma and urinary biomarkers were compared. The plasma KIM-1 levels were significantly higher in diabetic children than in the controls and in high-NA children than normo-NA children. Glycosylated hemoglobin (HbA1c) was identified as a significant risk factor for increased plasma KIM-1. The optimal cutoff for HbA1c when the plasma KIM-1 was > 23.10 pg/mL was 6.75% with an area under the curve of 0.77. For diabetic children with mildly increased albuminuria, the plasma KIM-1 complementary to MA may help increase the yield of detecting DN. Our findings also suggested an HbA1c cutoff of 6.75% correlated with increased plasma KIM-1.

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Are Tubular Injury Markers NGAL and KIM-1 Useful in Pediatric Neurogenic Bladder?

Journal of Clinical Medicine ◽

10.3390/jcm10112353 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2353

Author(s):

Joanna Bagińska ◽

Agata Korzeniecka-Kozerska

Keyword(s):

Neurogenic Bladder ◽

Kidney Injury ◽

Healthy Children ◽

Tubular Injury ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Activity Assessment ◽

Kidney Injury Molecule 1 ◽

Tract Infections ◽

Neutrophil Gelatinase

The lack of early biomarkers of renal damage in children with neurogenic bladder (NB) prompts us to investigate the role of promising proteins: neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1). This prospective analysis was conducted on 58 children with NB and 25 healthy children. We assessed urinary levels of NGAL and KIM-1 in both groups. Age, sex, anthropometric measurements, activity assessment, renal function, and urodynamics parameters were analyzed. The differences between the median uNGAL and uKIM-1 in the NB group compared to control were recorded. However, only uNGAL levels were statistically significantly higher. Statistically significant correlation was found between gender, recurrent urinary tract infections, bladder trabeculation, its compliance, activity assessment, and uNGAL. To conclude, elevated levels of uNGAL may be considered a biomarker of tubular injury in children with NB due to MMC in contrast to uKIM-1.

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