Curve For Neutrophil Gelatinase-associated Lipocalin Research Articles

Neutrophil Gelatinase-Associated Lipocalin and Interleukin-18 in the Prediction of Acute Kidney Injury in Sepsis Patients.

We assessed the predictive value of blood neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) in predicting the onset of acute kidney injury (AKI) in sepsis patients in the intensive care unit (ICU). In this retrospective analysis, we examined the medical records of sepsis patients admitted to the ICU. After ICU admission, blood samples were taken at 0h, 6h, 12h, 24h, and 48h. Using an enzyme-linked immunosorbent assay, the concentrations of serum creatinine, NGAL, and IL-18 were determined. This study comprised a total of 197 participants, 104 of whom had AKI and 93 of whom did not. Blood concentrations of NGAL and IL-18 increased prior to serum creatinine levels. Between 6-48hours after ICU administration, NGAL and IL-18 levels in the AKI group were considerably higher than those in the non-AKI group, and creatinine levels between the two groups were significantly different after 48hours. Based on receiver operating characteristic (ROC) curve analysis, the area under the curve of NGAL and IL-18 for predicting AKI was 0.781 and 0.883, respectively. Blood NGAL and IL-18 are potential biomarkers for the early prediction of AKI in sepsis patients in the ICU.

Neutrophil Gelatinase-Associated Lipocalin and Retinol-Binding Protein-4 as Biomarkers for Diabetic Kidney Disease

Aims: This study was designed to evaluate the conflicting association between 2 tubular protein markers including neutrophil gelatinase-associated lipocalin (NGAL) and retinol-binding protein-4 (RBP-4) with albuminuria and glomerular filtration rate (GFR) and calculate the accuracy of the role of NGAL and RBP-4 in diagnosis of diabetic nephropathy (DN) in patients with type2 diabetes. Methods: This is a cross-sectional study that included 133 patients with type 2 diabetes. There were 3 diabetic study groups with normoalbuminuria, moderately increased albuminuria, severely increased albuminuria, and non-diabetic control group without any renal disease. We analyzed the difference of urinary NGAL (uNGAL) and RBP-4 between nondiabetics and diabetics, as well as within the diabetic group. We also assessed the association between albuminuria and NGAL and RBP-4. Results: The urinary levels of NGAL and RBP-4 were higher in patients with type 2 diabetes compared to nondiabetics as well as in albuminuric diabetics compared to nonalbuminuric patients with diabetes (p value <0.001). These 2 proteins were higher in patients with severely increased albuminuria compared to patients with moderately increased albuminuria, even after adjustment for other metabolic factors (all p < 0.01). Moreover, areas under the curve of NGAL and RBP-4 for the diagnosis of chronic kidney disease were 80.6 and 74.6%, respectively. Conclusion: uNGAL and RBP-4 are potential markers of tubular damage that may increase before the onset of glomerular markers such as albuminuria and GFR in patients with type 2 diabetes. Therefore, these markers can be used as complementary measurements to albuminuria and GFR in the earlier diagnosis of DN.

Urinary N-acetyl-beta-d-glucosaminidase (NAG) with neutrophil gelatinase-associated lipocalin (NGAL) improves the diagnostic value for proximal tubule damage in diabetic kidney disease.

Screening for diabetic kidney disease (DKD) remains a challenge; however, there has been an ongoing research to investigate the diagnostic value of different biomarkers to identify DKD. The aim of this study was to assess the diagnostic value of both N-acetyl-beta-d-glucosaminidase (NAG) and neutrophil gelatinase-associated lipocalin (NGAL) in the progression of DKD. This cross-sectional case-control study included 92 type 2 diabetic patients with or without DKD. Urinary NAG and NGAL were measured to evaluate their diagnostic values as biochemical markers related to DKD. Both urinary NAG and NGAL levels were significantly higher among patients with DKD. In multiple linear regression analysis, NAG showed a positive significant association with NGAL in the three different adjusted models, while no significant correlation with fasting blood glucose, glycated hemoglobin, serum creatinine, estimated glomerular filtration rate, and albumin creatinine ratio were observed. The area under the curve for NGAL was 0.659 (p = 0.01) and 0.564 (p = 0.297) for NAG in DKD patients. This study demonstrates the association between urinary NAG and NGAL as a tubular damage marker for DKD although longitudinal studies are needed to evaluate its diagnostic value.

Serum neutrophil gelatinase-associated lipocalin levels predict the neurological outcomes of out-of-hospital cardiac arrest victims

BackgroundSerum neutrophil gelatinase-associated lipocalin (NGAL) is a well-known biomarker of acute kidney injury. Serum NGAL was recently proposed as a potential predictor of mortality in post cardiac arrest syndrome (PCAS) patients following out-of-hospital cardiac arrest (OHCA). However, the potential predictive value of NGAL for neurological outcomes is unknown. Therefore, we assessed the potential predictive value of NGAL for neurological outcomes after OHCA. We also compared its predictive value with that of neuron-specific enolase (NSE) as an established biomarker.MethodsBlood samples were prospectively collected from 43 PCAS patients following OHCA. Serum NGAL was measured on days 1 and 2, and NSE was measured on day 2. These biomarkers were compared between patients with favourable (cerebral performance category [CPC] 1–2) and unfavourable (CPC 3–5) outcomes. Receiver operating characteristic (ROC) curve analysis was performed.ResultsSerum NGAL and NSE on day 2 (both P < 0.001), but not NGAL on day 1 (P = 0.609), were significantly different between the favourable and unfavourable groups. In ROC curve analysis, the sensitivity and specificity were 83% and 85%, respectively, for NGAL (day 2) at a cutoff value of 204 ng/mL and were 84% and 100% for NSE (day 2) at a cutoff value of 28.8 ng/mL. The area under the ROC curve of NGAL (day 2) was equivalent to that of NSE (day 2) (0.830 vs. 0.918). Additionally, the area under the ROC curve in subgroup of estimated glomerular filtration rate (eGFR) > 20 mL/min/1.73 m2 (n = 38, 0.978 vs. 0.923) showed the potential of NGAL predictability.ConclusionsSerum NGAL might predict the neurological outcomes of PCAS patients, and its predictive value was equivalent to that of NSE.

Diagnostic value of neutrophil gelatinase-associated lipocalin for renal injury in asphyxiated preterm infants.

The aim of the present study was to analyze the diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL) in renal injury in asphyxiated preterm infants. In total, 48 cases of asphyxiated preterm infants, 45 cases of premature infants and 45 cases of normal newborn infants were included in the study. Using ELISA we evaluated the level of urine NGAL, kidney injury molecule-1 (KIM-1), cystatin C (Cys-C) and serum creatinine (Scr). We also calculated the estimated glomerular filtration rate (eGFR). Our results showed that NGAL, KIM-1 and Cys-C levels in the group of asphyxiant renal injury within 24 and 48 h were markedly higher than the other two groups (P<0.05), while changes in Scr and eGFR within 24 h were not significant (P>0.05). Scr level in renal injury group within 48 h was markedly elevated while the eGFR level was visibly reduced (P<0.05). According to analysis of receiver operating characteristic curve, area under curve for NGAL in the group of asphyxiant renal injury within 24 and 48 h was significantly higher than KIM-1 and Cys-C. Susceptibility and specificity were improved. In conclusion, diagnosis of renal injury in asphyxia neonates using NGAL was more efficient compared to other methods.

Plasma neutrophil gelatinase-associated lipocalin (NGAL) predicts renal function in hospitalized patients with heart failure

Objective To explore the prognostic value of baseline plasma neutrophil gelatinase-associated the lipocalin(NGAL ) for worsening renal function in heart failure (HF). Methods We consecutively enrolled 396 patients hospitalized with HF and used chronic kidney disease epidemiology collaboration (CKD-EPI) formula to calculate estimated glomerular filtration rate (eGFR). All patients were divided into 2 groups: cardiorenal syndrome (CRS) group [eGFR<60 ml/(min·1.73 m2), n=97] and non-CRS group [eGFR ≥ 60 ml/(min·1.73 m2), n=299], indicators measuring the concentration of NGAL two groups of patients, N-terminal pro-brain natriuretic peptide (NT-proBNP), creatinine, serum urea nitrogen (BUN). Results In correlation analysis, r value between NGAL and NT-proBNP, creatine, BUN was 0.194, 0.527, and 0.433, respectively (P<0.01). The area under the receiver operating characteristic (ROC) curve of NGAL, NT-proBNP, BUN to evaluate worsening renal function was 0.863, 0.681, and 0.828, respectively (P<0.01). Conclusions Plasma NGAL was an independent worsening renal function predictor for hospitalized patients with heart failure. Key words: Lipocalins/ME; Gelatinases/ME; Heart failure/CO/ME; Kidney diseases/CO/ME

Evaluation the urine NGAL and IL-18 as early predictive markers for delayed graft function following kidney transplantation

Objective To evaluate the predictive value of urinary neutrophil gelatinase-associat-ed lipocalin (NGAL) and interleukin-18 (IL-18) for delayed graft function (DGF) in kidney transplan-tation. Methods Serial urine samples collected at 0, 12 and 24 h after operation from 86 kidney transplantation patients were analyzed by enzyme-linked immunosorbent assay for NGAL, IL-18 and RBP. Results Fifteen patients developed DGF. At 12 h after transplantation, the level of urine NGAL elevated significantly (1712.75±474.6 vs. 863.1±199.8 without DGF, P 0. 05) was not significant. At 24 h, both urine NGAL(2905.0±1108.1 vs. 911.8±221.0 without DGF,P<0. 001) and IL-18(211.3± 34.0 vs. 86.9±22.8 without DGF, P<0. 001) increased significantly, whereas the changes of urine RBP and serum creatinine (SCr) were not significant. ROC analysis showed that the area under the curve of NGAL and IL-18 were 0. 90 and 0.76 respectively, the cut-off values were 996.5 ng/mg and 148.5 ng/mg, the diagnostic sensitivities in DGF were 90.2% and 76.3%, specificities were 82.6% and 66.4% respectively. Conclusions Both urine NGAL and IL-18 could potentially be early predic-tive marker of DGF. The level of NGAL elevated earlier than IL-18, which may be more effective in predicting DGF. Key words: Kidney transplantation; Delayed graft function (DGF); Forecasting

Urinary neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of acute kidney injury in critically ill multiple trauma patients

Neutrophil gelatinase-associated lipocalin (NGAL), an iron-transporting protein rapidly accumulating in the kidney tubules and urine after nephrotoxic and ischemic insults, has been put forward as an early, sensitive, non-invasive biomarker for acute kidney injury (AKI). The aim of this study was to evaluate urinary NGAL levels as a predictor of early AKI (first 5 days after injury) in multi-trauma patients. We studied multi-trauma adult patients admitted to the intensive care unit of a trauma hospital. Exclusion criteria were a) known cardiac or chronic kidney disease, and b) initial evaluation after more than 24 h had elapsed from injury. Urinary NGAL was measured using an ELISA technique upon admission and at 24 and 48 h. Presence of AKI was defined by the risk injury failure loss and end-stage kidney classification (RIFLE) criteria. Data are reported as median and interquartile range. A total of 31 patients (25 male, 6 female) were studied. NGAL levels at admission were significantly higher among patients who subsequently developed AKI [155.5 (50.5-205.9) ng/mL vs. 8.0 (5.7-17.7) ng/mL, p=0.0000] and these higher levels persisted over the following 2 days. On the basis of receiver-operating characteristic analysis both NGAL and serum creatinine baseline measurements could predict AKI [area under the curve (95% confidence interval) 0.977 (0.823-0.980) and 0.789 (0.556-0.906), respectively], but the area under the curve for NGAL was significantly larger (p=0.024). A cut-off point >25 ng/mL for NGAL had a sensitivity of 0.91 and specificity of 0.95 in predicting AKI. Urinary NGAL can be used from the 1st day of injury as a reliable predictor of early AKI in multi-trauma patients.