Evaluating Neutrophil Gelatinase-Associated Lipocalin as an Early Marker of Acute Kidney Injury in Critically Ill Patients

Abstract

Background: Detecting significant renal injury in an accurate and timely manner in acute kidney injury (AKI) patients who are critically ill remains controversial. Serum creatinine (Cr) is an important marker of kidney function in clinical practice, and its limitations are well known. Objectives: This study aimed to evaluate neutrophil gelatinase-associated lipocalin (NGAL) as a marker of the early development of AKI in critically ill AKI patients. Methods: This prospective study was carried out at JSS Hospital, Mysuru, India. The diagnosis and staging of AKI was done according to the RIFLE criteria. Results: A total of 53 critically ill patients were enrolled in this study. During Intensive Care Unit (ICU) stay, 34 (64.2%) patients developed AKI according to RIFLE criteria. Serum NGAL levels assessed on admission were an appropriate predictor of AKI com-pared to serum Cr. Serum NGAL levels also showed a significant elevation among AKI patients than non-AKI cases. The mean levels for AKI patients at 0, 4, and 8 hours were 870.53, 1074.9, and 1090, respectively. Meanwhile, the mean levels for non-AKI patients at 0, 4, and 8 hours were 337, 307, and 292. Conclusions: Measuring serum NGAL on admission is useful in the early diagnosis of AKI com-pared to serum Cr.