Usefulness of plasma neutrophil gelatinase-associated lipocalin as an early marker of acute kidney injury after cardiopulmonary bypass in Korean cardiac patients: A prospective observational study

Development of acute kidney injury (AKI) after cardiopulmonary bypass (CPB) is relatively common and associated with increased mortality. Recently, plasma neutrophil gelatinase-associated lipocalin (NGAL) was used for the prediction of AKI. We evaluated the clinical usefulness of plasma NGAL. One hu...

Full description

Saved in:
Bibliographic Details
Published in:Clinical biochemistry 2015-01, Vol.48 (1-2), p.44-49
Main Authors: Park, Chul Min, Kim, Jun Seok, Moon, Hee-Won, Park, Seungman, Kim, Hanah, Ji, Misuk, Hur, Mina, Yun, Yeo-Min
Format: Article
Language:English
Subjects:
Acute kidney injury
Acute Kidney Injury - blood
Acute Kidney Injury - etiology
Acute-Phase Proteins
Aged
Asian Continental Ancestry Group
Biomarkers - blood
Cardiopulmonary bypass
Cardiopulmonary Bypass - adverse effects
Creatinine - blood
Early biomarker
Female
Humans
Lipocalin-2
Lipocalins - blood
Logistic Models
Male
Middle Aged
Multivariate Analysis
Plasma NGAL
Preoperative Care
Prospective Studies
Proto-Oncogene Proteins - blood
ROC Curve
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Development of acute kidney injury (AKI) after cardiopulmonary bypass (CPB) is relatively common and associated with increased mortality. Recently, plasma neutrophil gelatinase-associated lipocalin (NGAL) was used for the prediction of AKI. We evaluated the clinical usefulness of plasma NGAL. One hundred twelve adult patients undergoing cardiovascular surgery with CPB were included. Blood samples were obtained at baseline, at intensive care unit (ICU) admission, and 24h after ICU admission. The development of AKI, which is defined as an increase in serum creatinine by more than 50% within 3 postoperative days, was monitored. NGAL levels were analyzed by a Biosite Triage meter (Alere Medical, USA). Diagnostic performance of NGAL was analyzed using the area under the receiver operating characteristic curve. In AKI patients (n=13), plasma NGAL levels at ICU admission were significantly higher than those at baseline [177 (122–402) vs. 121 (74–158) ng/mL, median (interquartile range), p=0.028], whereas serum creatinine showed no significant change. The predictive value of NGAL at ICU admission was 0.812 [95% confidence interval (CI), 0.68 to 0.95] with a cut-off value of 168.5ng/mL (sensitivity, 61.5%; specificity, 88.9%). After the exclusion of 35 patients with preoperative decreased renal function, the predictive value was increased to 0.911 (95% CI, 0.82 to 1.00). This study showed that plasma NGAL may serve as a useful biomarker for the early detection of AKI in adult patients following CPB. •Usefulness of NGAL as an early biomarker for detecting acute kidney injury•Performance of plasma NGAL was superior in patients with normal renal function.•Preliminary cut-off of 168.5ng/mL suggested
ISSN:0009-9120
1873-2933
DOI:10.1016/j.clinbiochem.2014.09.019