The value of plasma NGAL and NT-proBNP in the diagnosis of type 1 cardiorenal syndrome

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background The presence of acute kidney injury in the setting of acute heart failure (AHF) is common occurrence and was termed type 1 cardiorenal syndrome (CRS1). Neutrophil gelatinase-associated lipocalin (NGAL) is one of the earliest biomarkers of acute kidney injury due to ischemia or renal toxicity. NT-proBNP has a role in the diagnosis of acute heart failure. Does the combination of NGAL and NT-proBNP increase diagnostic value of CRS1? This study was aimed to evaluate the diagnostic value of plasma NGAL and NT-proBNP in diagnosis of CRS1. Methods there were 139 patients with AHF in the department of Cardiovascular resuscitation and Interventional cardiology Ho Chi Minh City Vietnam 115 People Hospital from September 2018 to March 2019. This was a prospective cohort study. Results the optimal cut-off plasma NGAL to diagnosing CRS1 was 353.23 ng/ml, Area Under Curve (AUC) 0.732 (95% CI 0.65-0.80, p < 0.001), sensitivity 74.47%, specificity 68.48%, positive predictive value 54.7%, negative predictive value 84%. The optimal cut-off NT-proBNP to diagnosing CRS1 was 17681 pg/ml, AUC 0.710 (95% CI 0.627-0.784, p < 0.001), sensitivity 54.2%, specificity 80.2%, positive predictive value 59.1%, negative predictive value 76.8%. Combination of plasma NGAL and NT-proBNP in diagnosing CRS1 with AUC 0.756 (95% CI 0.676-0.825, p < 0.001), sensitivity 77.1%, specificity 69.2%, positive predictive value 56.9%, negative predictive value 85.1%. Conclusions Combination of plasma NGAL and NT-proBNP in the diagnosis of type 1 cardiorenal syndrome with higher sensivity than each biomarker.