Neutrophil gelatinase-associated lipocalin levels during the first 48 hours of intensive care may indicate upcoming acute kidney injury

Abstract Purpose The recognition of acute kidney injury (AKI) as early as possible is important in the intensive care unit (ICU). This study proposes that serum and urine levels of neutrophil gelatinase-associated lipocalin (NGAL) may use for this purpose. Methods One hundred and seven critically il...

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Bibliographic Details
Published in:Journal of critical care 2016-08, Vol.34, p.89-94
Main Authors: Kamis, Fatih, Yegenaga, Itir, Musul, Mert, Baydemir, Canan, Bek, Sibel, Kalender, Betül, Baykara, Nur
Format: Article
Language:English
Subjects:
Acute kidney injury
Acute Kidney Injury - blood
Acute Kidney Injury - diagnosis
Acute Kidney Injury - urine
Adult
Aged
Area Under Curve
Biomarker
Biomarkers
Biomarkers - blood
Biomarkers - urine
Confidence intervals
Critical Care
Critical Illness
Critically ill
Early Diagnosis
Family medical history
Female
Heart attacks
Hospitals
Humans
Intensive care
Intensive Care Units
Kidneys
Laboratories
Lipocalin-2 - blood
Lipocalin-2 - urine
Male
Middle Aged
Mortality
Neutrophils
NGAL
Prospective Studies
ROC Curve
Sensitivity and Specificity
Sepsis
Urine
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Summary:Abstract Purpose The recognition of acute kidney injury (AKI) as early as possible is important in the intensive care unit (ICU). This study proposes that serum and urine levels of neutrophil gelatinase-associated lipocalin (NGAL) may use for this purpose. Methods One hundred and seven critically ill adult patients with no previous renal failure were included. NGAL levels were measured during the first 48 hours after admission; NGAL levels were followed for 7 days and classified based on Risk, Injury, Failure, Loss, and End-Stage Renal Failure (RIFLE) criteria. Results The AKI incidence was 35.5%, and serum NGAL (sNGAL) and urinary NGAL (uNGAL) levels were higher in the AKI group. The area under the receiver operating characteristic curve (AUC-ROC) for sNGAL was 0.76 (P < .001) and for uNGAL was 0.75 (P < .001). 71% of AKI cases observed within 48 hours, with 11 additional cases in the ensuing 7 days. The mean serum creatinine levels in the 11 patients were not different from non-AKI levels (P = .197), but the NGAL values were different, and the AUC-ROC for sNGAL uNGAL were 1.00 (P = .014) and 0.93 (P = .02), respectively. Conclusions Most AKI cases diagnosed within the first 48 hours after admission, and NGAL was useful for predicting upcoming AKI.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2016.04.012