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

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.

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Urinary Neutrophil Gelatinase-Associated Lipocalin as Predictor for Development of Hepatorenal Syndrome in Patients with Hepatic Cirrhosis

Afro-Egyptian Journal of Infectious and Endemic Diseases ◽

10.21608/aeji.2014.17193 ◽

2014 ◽

Vol 4 (3) ◽

pp. 143-148

Author(s):

Jihan Shawky ◽

Soha Khorshed ◽

Hany Labib

Keyword(s):

Hepatic Cirrhosis ◽

Hepatorenal Syndrome ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

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

International Journal of Research and Review ◽

10.52403/ijrr.20210750 ◽

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.

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Evaluation of Neutrophil Gelatinase-Associated Lipocalin in Children with Sydenham's Chorea Accompanying Valvular Regurgitation

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0038-1666792 ◽

2018 ◽

Vol 13 (04) ◽

pp. 293-299

Author(s):

Köksal Deveci ◽

Ahmet Guven ◽

Demet Alaygut ◽

Mehmet Oflaz

Keyword(s):

Immune Response ◽

Total Protein ◽

Valvular Regurgitation ◽

Urinary Ngal ◽

Creatinine Ratio ◽

Ngal Level ◽

Urine Ngal ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Sydenham's Chorea ◽

Neutrophil Gelatinase

Background Acute rheumatic fever (ARF) is a nonsuppurative complications of Group A β-hemolytic streptococcal (GABHS) infection due to a delayed immune response. Sydenham's chorea (SC) is an important neurological manifestation of ARF, and heart involvement is seen in a large proportion of patients with SC. The immune system has a crucial role in initiating and spreading inflammation, which causes tissue damage in ARF. Aim The purpose of this study was to investigate urine neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for kidney injury in children with rheumatic chorea accompanying valvular involvement. Materials and Methods Twenty-eight consecutive children with SC accompanying evidence of valvular involvement, and 30 nonrheumatic, age- and sex-matched healthy children were included in the study. Cardiac evaluations were performed, and urinary NGAL, micro-total protein and creatinine levels were measured in all participants. Results Age, gender, weight, and height were similar in the patients and controls. Twenty-three patients had isolated mitral regurgitation, and five patients had mitral and aortic regurgitation. While there was no statistically significant difference between the urine creatinine and micro-total protein levels in patients and controls, the patient group demonstrated a significantly higher mean urine NGAL level (18.01 ± 7.9 vs. 3.22 ± 1.4, p = 0.002) and mean urine NGAL/creatinine ratio (2.80 ± 1.9 vs. 0.33 ± 0.1, p = 0.008). However, there were no correlations between severity of chorea and urinary NGAL or urinary NGAL/creatinine ratio, there were significant positive correlations between severity of valvular regurgitation and urinary NGAL (r = 0.751, p < 0.001) and urinary NGAL/creatinine ratio (r = 0.694, p < 0.001). Conclusion The present study revealed that urinary NGAL level and urinary NGAL/creatinine ratio were higher in patients with SC accompanying valvular involvement. The results obtained from this study suggest that ARF may cause subclinical renal injury in patients with intense and prolonged cellular immune response leading to chorea and carditis.

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Urinary neutrophil gelatinase-associated lipocalin in early detection of diabetic nephropathy; a pilot study

Journal of Renal Injury Prevention ◽

10.34172/jrip.2020.23 ◽

2020 ◽

Vol 9 (3) ◽

pp. e23-e23

Author(s):

Mohammad Saad Forghani ◽

Fowzieh Khezrian ◽

Somayeh Khezrian ◽

Shahnaz Ghafoori ◽

Lotfollah Saed ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Early Detection ◽

Significant Relationship ◽

Demographic Data ◽

Diabetic Patients ◽

Urinary Ngal ◽

Ngal Level ◽

Duration Of Diabetes ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

Introduction: Diabetes results in the high prevalence of diabetes and the subsequent high incidence of nephropathy. However, there is no method with high sensitivity for the early detection of diabetic kidney disease. Objectives: The objective of this study was to evaluate the effect of the frequency of neutrophil gelatinase-associated lipocalin (NGAL) in the early diagnosis of diabetic nephropathy. Patients and Methods: Seventy-six diabetic patients who referred to the diabetes clinic of Tohid hospital were randomly selected and enrolled into this cross-sectional study. Patients with hypertension, primary and secondary glomerulopathy, every type of malignancy, infection, heart disease, pulmonary disease and other endocrine diseases, and significant renal failure (estimated glomerular filtration rate; eGFR≤30 mL/min) were excluded from the study. Demographic data were collected and the patients were divided into normal and abnormal groups based on the results of urine tests. Morning urine samples were then taken from the patients to measure creatinine, albumin, urine Alb/CR (albumin to creatinine) ratio and NGAL. Results: Of a total of 76 patients who were enrolled in the study, 39 persons (51.3%) were female. The mean age of the participants was 59.03 ± 11.74 years. In addition, 64 patients (84.2%) were in the normoalbuminuria group and 12 persons (15.8%) were in the microalbuminuria group. Urinary NGAL level was significantly higher in the microalbuminuria group than in the normal group since the difference was significant (P<0.001). We found urinary NGAL level had no significant relationship with eGFR value and the duration of diabetes (P>0.05). There was also a relationship between urinary NGAL and urinary Alb/CR ratio levels (P=0.001). Conclusion: The results of the present study showed a relationship between urinary NGAL and urine Alb/CR ratio levels which could be used as a suitable biomarker in the diagnosis of diabetic nephropathy. Moreover, urinary NGAL level had no significant relationship with eGFR and the duration of diabetes.

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STUDY OF URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) IN PATIENTS WITH LIVER CIRRHOSIS AND ITS RELATION TO HEPATORENAL SYNDROME

Journal of the Medical Research Institute ◽

10.21608/jmalexu.2015.111548 ◽

2015 ◽

Vol 36 (2) ◽

pp. 40-49

Keyword(s):

Liver Cirrhosis ◽

Hepatorenal Syndrome ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

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

Journal of Biomarkers ◽

10.1155/2013/413853 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 5

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.

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

Archives of Biological Sciences ◽

10.2298/abs190604044c ◽

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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