scholarly journals Urinary Neutrophil Gelatinase-Associated Lipocalin in Type 1 and Type 2 Hepatorenal Syndrome and Its Correlation with Kidney Function

2021 ◽  
Vol 8 (7) ◽  
pp. 359-364
Author(s):  
Lider Olmen Panggabean ◽  
Gontar Alamsyah Siregar ◽  
Dharma Lindarto
Keyword(s):  
Liver Disease ◽  
Disease Severity ◽  
Kidney Function ◽  
Hepatorenal Syndrome ◽  
Urinary Ngal ◽  
Positive Correlation ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Objective: To determine the difference in urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) levels ​​in type 1 and type 2 Hepatorenal Syndrome (HRS) and determine the correlation between urinary NGAL and kidney function and the degree of liver disease severity in HRS patients. Methods: A total of 26 patients consisting of 13 patients in each group, both in type 1 and type 2 HRS at Adam Malik Hospital, Medan City, Indonesia. Urine samples were taken for NGAL examination using the ELISA method. A blood sample is used to assess kidney function. Liver disease severity was measured using the Child-pugh score. Data were analyzed using statistical t-test independent and Pearson correlation test. A p value less than 0.05 was applied to each statistical test as significant. Result: Total subjects consisted of 18 men and 8 women, with a mean age 57.5±8.91 years old. Hepatitis B virus was the most common etiology of liver cirrhosis in this study (53.8%) and the most degree of liver disease severity was Child-pugh C (65.4%). Urinary NGAL levels in type 1 HRS is significantly higher than type 2 (155.71±43.04 vs 105.85±32.32 ng/ml, p = 0.003). There was a positive correlation between uNGAL and serum creatinine (r = 0.488, P = 0.006). There was a positive correlation between uNGAL and Child-pugh score (r = 0.466, P = 0.008). Conclusion: Urinary NGAL level in type 1 HRS is higher than type 2, there is a positive correlation between uNGAL and serum creatinine and Child-pugh score in HRS patients. Keywords: Hepatorenal syndrome, urinary NGAL, Liver cirrhosis, kidney function.

scholarly journals The Difference of Urinary Neutrophil Gelatinase-Associated Lipocalin Level between Liver Cirrhosis Patients with and without Hepatorenal Syndrome

2022 ◽  
Vol 9 (1) ◽  
pp. 1-8
Author(s):  
Fakhrurrazi Nasution ◽  
Gontar Alamsyah Siregar ◽  
Ilhamd .
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Cirrhosis ◽  
Hepatorenal Syndrome ◽  
Urinary Ngal ◽  
Ngal Level ◽  
Elisa Method ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
B Virus ◽  
The Difference ◽  
Neutrophil Gelatinase

Objective: To determine differences of urinary Neutrophil Gelatinase-Associated Lipocalin level in liver cirrhosis patients with or without Hepatorenal Syndrome (HRS). Methods: This study was conducted on 46 liver cirrhosis patients (20 patients without hepatorenal syndrome, 26 patients with hepatorenal syndrome). Diagnosis of HRS was based on International Ascites Club criteria. Urinary NGAL was examined using ELISA method. Data analysis was performed with p<0,05 stated as statistically significant. Result: This study showed more HRS cases was found in male than female, with an average age of 53,95 years old for hepatic cirrhosis without HRS, and 57,35 with HRS. The most common cause of this study is Hepatitis B virus, and the highest grade of severity is in Child Pugh-C. The average urinary NGAL level in liver cirrhosis with HRS is 59,39 ± 58,98 ng/ml and 130,78 ± 45,14 ng/ml in liver cirrhosis without HRS. Conclusion: There was a significant higher urinary NGAL level in liver cirrhosis with HRS (p = 0.000), with the cut-off of urinary NGAL to differentiate cirrhosis patients with and without HRS was 95,115 ng/ml. Keywords: NGAL, HRS, hepatorenal syndrome, neutrophil gelatinase-associated lipocalin.

scholarly journals Is Urinary NGAL Determination Useful for Monitoring Kidney Function and Assessment of Cardiovascular Disease? A 12-Month Observation of Patients with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Agnieszka Żyłka ◽  
Agnieszka Gala-Błądzińska ◽  
Paulina Dumnicka ◽  
Piotr Ceranowicz ◽  
Marek Kuźniewski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Function ◽  
Diabetic Kidney Disease ◽  
Cardiovascular Complications ◽  
Tubular Damage ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Urine Albumin ◽  
One Year ◽  
Neutrophil Gelatinase

Background. Diabetic kidney disease (DKD) may start as glomerular or tubular damage. We assessed kidney function during one-year-long observation of patients with type 2 diabetes mellitus (T2DM) after initiation of nephroprotective treatment, with emphasis on the changes in urinary neutrophil gelatinase-associated lipocalin (uNGAL), and evaluated the association between tubular damage and cardiovascular complications of T2DM.Materials and Methods. Adult T2DM patients (55) were assessed initially and 30 patients after 1 year. Albumin and uNGAL and creatinine were measured in first morning urine. Albumin/creatinine (uACR) and uNGAL/creatinine (uNCR) ratios were calculated.Results. In logistic regression, both uACR above 30 mg/g and uNCR the median (21.3 μg/g) were associated with cardiovascular complications, independently of classical risk factors and diabetes duration. One year after initiation of treatment, a significant reduction inHbA1cwas observed. BMI and lipid profiles did not change. Increase in serum creatinine and reduction in eGFR occurred, along with decrease in uNGAL and uNCR. Increasing uNCR and uACR were associated with higher controlHbA1c. The increase in uNCR was more frequent in patients with hypertension.Conclusions. Better glycemic control in T2DM patients results in improved tubular function, as reflected by reduced uNCR and uNGAL. First morning urine uNGAL and uNCR may be useful to assess renal function and cardiovascular risk, along with albuminuria and eGFR.

Diagnostic Accuracy of Neutrophil Gelatinase-Associated Lipocalin for Predicting Early Diabetic Nephropathy in Patients with Type 1 and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

2019 ◽  
Vol 4 (1) ◽  
pp. 78-94 ◽  
Author(s):  
Georgia V Kapoula ◽  
Panagiota I Kontou ◽  
Pantelis G Bagos
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Healthy Individuals ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase ◽  
Serum And Urine

Abstract Background Currently, there is a lack of prediction markers for diabetic nephropathy (DN) in patients with type 1 and type 2 diabetes mellitus (T1DM/T2DM). The aim of this systematic review and meta-analysis was to evaluate the value of a promising biomarker, neutrophil gelatinase-associated lipocalin (NGAL), in both serum and urine for the diagnosis of early DN in T1DM and T2DM patients with different stages of albuminuria. Methods A comprehensive search was performed on PubMed by 2 reviewers until September 2018. Studies in which (a) the degree of DN was determined according to the urinary albumin/creatinine ratio and (b) NGAL was measured in healthy individuals and in diabetes patients with DN were included in the meta-analysis. For each study, a 2 × 2 contingency table was formulated. Sensitivity, specificity, and other estimates of accuracy were calculated using a bivariate random effects model. The hierarchical summary ROC method was used to pool data and to evaluate the area under the curve (AUC). The sources of heterogeneity were explored by subgroup analysis. Publication bias was assessed using the Deeks test. Results The meta-analysis enrolled 22 studies involving 683 healthy individuals and 3249 patients with diabetes, of which 488 were T1DM and 2761 were T2DM patients. Overall, pooled sensitivity and specificity among the different settings analyzed ranged from 0.42 (95% CI, 0.22–0.66) to 1.00 (95% CI, 0.99–1.00) and 0.72 (95% CI, 0.62–0.80) to 0.98 (95% CI, 0.50–1.00) in T2DM patients, respectively. For T1DM patients, the corresponding estimates were 0.71 (95% CI, 0.59–0.81) to 0.89 (95% CI, 0.64–0.97) and 0.72 (95% CI, 0.62–0.80) to 0.79 (95% CI, 0.67–0.87). The AUC of NGAL for T2DM patients ranged from 0.69 (95% CI, 0.65–0.73) to 1.00 (95% CI, 0.99–1.00) in the different settings. Conclusion The results of this meta-analysis suggest that NGAL in both serum and urine can be considered a valuable biomarker for early detection of DN in diabetes patients.

scholarly journals Urinary matrix metalloproteinase activities: biomarkers for plaque angiogenesis and nephropathy in diabetes

2011 ◽  
Vol 301 (6) ◽  
pp. F1326-F1333 ◽  
Author(s):  
Ian B. McKittrick ◽  
Yolanda Bogaert ◽  
Kristen Nadeau ◽  
Janet Snell-Bergeon ◽  
Amber Hull ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Matrix Metalloproteinase ◽  
Vascular Malformation ◽  
Diabetic Complications ◽  
Vascular Remodeling ◽  
Vascular Complications ◽  
Urinary Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Diabetic complications of nephropathy and accelerated atherosclerosis are associated with vascular remodeling and dysregulated angiogenesis. Matrix metalloproteinases (MMP) modify extracellular matrix during vascular remodeling and are excreted in urine of patients with vascular malformation or tumor angiogenesis. We hypothesized that urinary MMP activities would be sensitive biomarkers for vascular remodeling in diabetic complications. Activities of MMP-2, MMP-9, and its complex with neutrophil gelatinase-associated lipocalin (NGAL/MMP-9) were measured by substrate gel zymography in urine from nondiabetic (ND) and type 1 diabetic (T1D) rodents that were susceptible to both T1D-induced plaque angiogenesis and nephropathy, or nephropathy alone. Additionally, these urine activities were measured in ND and T1D adolescents. Urinary MMP-9, MMP-2, and NGAL/MMP-9 activities were increased and more prevalent in T1D compared with ND controls. Urinary MMP-2 activity was detected in mice with T1D-induced plaque neovascularization. In nephropathy models, urinary NGAL/MMP-9 and MMP-9 activities appeared before onset of albuminuria, whereas MMP-2 was absent or delayed. Finally, urinary MMP activities were increased in adolescents with early stages of T1D. Urinary MMP activities may be sensitive, noninvasive, and clinically useful biomarkers for predicting vascular remodeling in diabetic renal and vascular complications.

scholarly journals Comparison of urine neutrophil gelatinase-associated lipocalin to serum creatinine to assess kidney function in neonatal asphyxia

2017 ◽  
Vol 56 (6) ◽  
pp. 356 ◽  
Author(s):  
Winston Leonardo Tanzil ◽  
Rocky Wilar ◽  
Max Frans Josef Mantik ◽  
Adrian Umboh ◽  
Suryadi Nicolaas Napoleon Tatura
Keyword(s):  
Serum Creatinine ◽  
Kidney Function ◽  
Predictive Value ◽  
Kidney Tissue ◽  
Kidney Injury ◽  
Urinary Ngal ◽  
Cross Sectional ◽  
Neonatal Asphyxia ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Background Infants with neonatal asphyxia have multiorgan damage, such as to the kidneys (50%), central nervous system (28%), cardiovascular system (25%), and lungs (23%). Neonatal asphyxia reduces kidney perfusion, often leading to acute kidney injury (AKI) after asphyxia. Neutrophil gelatinase-associated lipocalin (NGAL) levels in the blood, urine and kidney tissue increased rapidly in AKI. Urinary NGAL is proposed to have better performance in diagnosing AKI than creatinine due to its earlier, rapid level increase and it is less invasive.Objective To compare urinary NGAL to serum creatinine as a marker to assess kidney function in neonatal asphyxia.Methods Diagnostic comparison study with cross-sectional design was performed at neonatal intensive care unit (NICU) of Prof. Dr. R. D. Kandou Hospital, Manado from November 2015 to February 2016. All subjects had neonatal asphyxia. Data were analyzed using descriptive analysis, receiver-operator characteristic (ROC) curve, and Z-test.Results Urinary NGAL with cut-off point of 652.24 ng/mL can predict AKI in neonates with asphyxia with 100% sensitivity, 75% specificity, 52.3% positive predictive value, and 100% negative predictive value. Chi-square test resulted in a value of x2 = 20.036, P=0.0001).This shows that urinary NGAL levels >652,24 ng/mL can predicts AKI by 20 times in infants with neonatal asphyxia. So, urinary NGAL performs better than serum creatinine, therefore it can replace serum creatinine as an alternative non-invasive diagnostic test for diagnosing AKI in infants with neonatal asphyxia.Conclusion The diagnostic value of urinary NGAL is higher than that of serum creatinine in assessing kidney function in neonatal asphyxia. 

scholarly journals Clinical Practice of Hepatorenal Syndrome: A Brief Review on Diagnosis and Management

2021 ◽  
Vol 3 (2) ◽  
pp. 1-7
Author(s):  
. Rendy ◽  
. Febyan ◽  
Krisnhaliani Wetarini
Keyword(s):  
Clinical Practice ◽  
Hepatorenal Syndrome ◽  
Organ Transplant ◽  
Kidney Injury ◽  
Therapeutic Measures ◽  
Clinical Conditions ◽  
Underlying Pathophysiology

The hepatorenal syndrome is one of various potential causes of acute kidney injury in patients with decompensated liver disease. Hepatorenal syndrome is diagnosed based on reducing kidney function without any evidence of intrinsic kidney disease, including proteinuria, hematuria, or abnormal kidney ultrasonography. Clinically, hepatorenal syndrome is divided into two types named type 1 and type 2. The most favorable therapy for HRS cases is liver transplantation; however, only a few undergo this procedure due to the high mortality. Other modalities for hepatorenal syndrome therapy are pharmacology and non-pharmacology approaches. The purpose of management HRS is to optimize and stabilize the patient until an organ transplant available. This review aims to discuss the underlying pathophysiology and demonstrate the diagnostic approach of hepatorenal syndrome to determine the most appropriate therapeutic measures in clinical practice. The clinicians must be aware of management principles of hepatorenal syndrome to improve the quality of care for patients and optimize the clinical conditions.

scholarly journals Urinary Measurement of Neutrophil Gelatinase Associated Lipocalin and Kidney Injury Molecule-1 Helps Diagnose Acute Pyelonephritis in a Preclinical Model

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Hahn-Ey Lee ◽  
Sun Hee Lee ◽  
Minki Baek ◽  
Hwang Choi ◽  
Kwanjin Park
Keyword(s):  
Acute Pyelonephritis ◽  
Time Course ◽  
Kidney Injury ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Preclinical Model ◽  
Urinary Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Kidney Injury Molecule 1 ◽  
Neutrophil Gelatinase

Background. The study assessed whether measurement of urinary biomarkers of acute kidney injury could be helpful in diagnosing acute pyelonephritis and subsequent scarring. Method. Escherichia coli J96 (0.3 mL inoculum containing 1×109/mL) was directly injected into the renal cortex of 3-week-old female Sprague Dawley rats (n=20), with saline substituted in a control group (n=10). Following the injection, urine was collected 2, 7, 14, 28, and 42 days after injection. Urinary neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (Kim-1), and interleukin-18 were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). The levels of the biomarkers were adjusted for creatinine. Time course changes within a group or between the groups were compared. Correlation analysis was performed to understand the relationship between urinary levels and histological scarring. Results. Significantly elevated urinary NGAL was evident at two and seven days after injection, and Kim-1 was elevated at two days after injection. Receiver operating characteristic analyses confirmed the sensitivity of these markers at these times. No urinary marker at acute stage of APN was correlated with the amount of future scarring, negating their predictive value. Conclusion. Urinary NGAL and Kim-1 could be helpful in diagnosing febrile urinary tract infection in children.

scholarly journals Relationship between neutrophil gelatinase-associated lipocalin, cardiac biomarkers, inflammation index and renal parameters in cardiovascular disease

2019 ◽  
Vol 71 (4) ◽  
pp. 621-628
Author(s):  
Jong Choi ◽  
Moon Lee ◽  
Tatsuyoshi Fujii
Keyword(s):  
Kidney Function ◽  
Troponin I ◽  
Myocardial Dysfunction ◽  
Cardiac Biomarkers ◽  
Ngal Level ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Plasma Ngal ◽  
Creatine Kinase Mb ◽  
Index Ratio ◽  
Neutrophil Gelatinase

The plasma neutrophil gelatinase-associated lipocalin (NGAL) level is elevated in myocardial infarction (MI) and affected by inflammation and kidney function. The aim of this study was to determine which of these conditions more critically affects the plasma NGAL level in MI. Patients with MI were evaluated by measuring the NGAL concentration and its corrected values. No significant association was observed between plasma NGAL concentration and cardiac biomarkers. However, the NGAL/inflammation index ratio (NGAL/Inf ratio) was positively correlated with troponin-I (r=0.289, p<0.001), and the NGAL/serum creatinine ratio (NGAL/sCr ratio) was significantly correlated with creatine kinase-MB (r=0.251, p<0.001). After adjusting for inflammation and kidney function, increased NGAL concentrations returned to baseline levels, which were not different from those of healthy individuals. The percent difference between NGAL and the NGAL/Inf ratio was 35.6%, significantly higher than that between NGAL and the NGAL/sCr ratio (15.4%; p<0.001). The severity of inflammation seems to play a more crucial role than renal and myocardial dysfunction in affecting plasma NGAL levels in MI. Plasma NGAL levels need to be corrected using the inflammation index and sCr levels for exactly evaluating patients with MI.

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