Abstract

BackgroundUrine neutrophil gelatinase‐associated lipocalin (NGAL) is a promising biomarker of acute kidney injury (AKI) in dogs.ObjectivesTo evaluate the utility of urinary NGAL for characterizing AKI according to volume responsiveness, presence of inflammation and sepsis, and prognosis.AnimalsDogs with AKI (n = 76) and healthy controls (n = 10).MethodsProspective study. Clinical and clinicopathologic data including absolute urine NGAL concentration (uNGAL) and NGAL normalized to urine creatinine concentration (uNGALC) were measured upon admission. Dogs were graded according to International Renal Interest Society (IRIS) AKI guidelines and compared based on AKI features: volume‐responsive (VR‐) AKI vs. intrinsic (I‐) AKI based on IRIS criteria; VR‐AKI and I‐AKI based on urine chemistry; inflammatory versus noninflammatory; septic versus nonseptic; and survivors versus nonsurvivors. Nonparametric statistics were calculated, and significance set at P < .05.ResultsUrinary NGAL was significantly higher in dogs with AKI compared to controls, regardless of AKI grade. Urinary NGAL did not differ between dogs with VR‐AKI and I‐AKI based on IRIS criteria, whereas higher uNGALC was recorded in dogs with I‐AKI based on urine chemistry. Urinary NGAL was significantly higher in dogs with inflammatory AKI, whereas no difference with respect to sepsis or outcome was identified.Conclusions and Clinical ImportanceUrinary NGAL is a sensitive marker for AKI in dogs, but its specificity is affected by systemic inflammation. Increased urinary NGAL in both I‐AKI and VR‐AKI also suggests the presence of tubular damage in transient AKI. Combining urine chemistry data with IRIS criteria could facilitate AKI characterization in dogs.

Highlights

  • Acute kidney injury (AKI) is defined as sudden onset of renal damage or dysfunction

  • Our results suggest that urine NGAL concentration (uNGAL) measured in urine samples collected at the time of acute kidney injury (AKI) diagnosis is a sensitive marker of AKI in dogs

  • UNGAL during AKI seems to be affected by systemic inflammation and, in our study population, was not associated with AKI severity, prognosis, or the presence of sepsis

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Summary

Introduction

One of the most studied biomarkers for the early diagnosis of AKI in humans is neutrophil gelatinase-associated lipocalin (NGAL). It is a 25 kDA protein belonging to the lipocalin family. Urine neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker of acute kidney injury (AKI) in dogs. Dogs were graded according to International Renal Interest Society (IRIS) AKI guidelines and compared based on AKI features: volume-responsive (VR-) AKI vs intrinsic (I-) AKI based on IRIS criteria; VR-AKI and I-AKI based on urine chemistry; inflammatory versus noninflammatory; septic versus nonseptic; and survivors versus nonsurvivors. Urinary NGAL did not differ between dogs with VR-AKI and I-AKI based on IRIS criteria, whereas higher uNGALC was recorded in dogs with I-AKI based on urine chemistry. Combining urine chemistry data with IRIS criteria could facilitate AKI characterization in dogs

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