Serum neutrophil gelatinase-associated lipocalin correlates with kidney function in renal allograft recipients

• Published in: Clinical transplantation 2009-09, Vol.23 (5), p.681-686
• Main Authors: Malyszko, Jolanta, Malyszko, Jacek S., Mysliwiec, Michal
• Format: Article
• Language: English
• Subjects: Acute-Phase Proteins; Adult; Aged; Biological and medical sciences; Biomarkers - blood; Cross-Sectional Studies; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glomerular Filtration Rate; Humans; Immunosuppressive Agents - therapeutic use; kidney function; Kidney Transplantation; Lipocalin-2; Lipocalins - blood; Male; Medical sciences; Middle Aged; NGAL; Pilot Projects; Prognosis; Proto-Oncogene Proteins - blood; Renal Insufficiency - blood; Renal Insufficiency - drug therapy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue, organ and graft immunology; Transplantation, Homologous; Treatment Outcome
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2009.01034.x

:  The value of neutrophil gelatinase‐associated lipocalin (NGAL) as a novel marker for early detection of acute renal failure has been highlighted recently. The aim of this study was to assess whether serum NGAL correlates with kidney function in kidney allograft recipients. Serum NGAL, creatinine, and estimated glomerular filtration rate (GFR) were evaluated in 100 kidney allograft recipients on triple therapy: calcineurin inhibitor, mycophenolate mofetil or azathioprine, prednisone and healthy volunteers. Kidney transplant recipients had significantly higher NGAL than the control group. Serum NGAL in univariate analysis was strongly correlated with serum creatinine (r = 0.78). Estimated GFR (r = −0.69), on the other hand, was moderately correlated with white blood cell count (r = 0.43) and only weakly with other parameters. In multiple regression analysis, the best predictor of serum NGAL was eGFR (beta −0.69), with other predictors being white blood cell count (beta 0.25) and high sensitivity C‐reactive protein (hsCRP) (beta 0.23) explaining 82% of NGAL concentration. Even a successful kidney transplantation is associated with kidney injury as reflected by elevated serum NGAL and lowered eGFR. Therefore, NGAL needs to be investigated as a potential early marker for impaired kidney function/kidney injury, especially in patients with other risk factor for kidney damage, i.e., hypertension or diabetes.