Document Detail


Neutrophil gelatinase-associated lipocalin in the diagnosis of type 1 cardio-renal syndrome in the general ward.
MedLine Citation:
PMID:  21115620     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: The early identification of acute heart failure (HF) patients with type 1 cardio-renal syndrome should be the first step for developing prevention and treatment strategies for these patients. This study aimed to assess the performance of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in the early detection of type 1 cardio-renal syndrome in patients with acute HF.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: One-hundred nineteen patients admitted with acute HF were studied. NGAL and creatinine were measured in the first hospitalization morning; creatinine was also measured at least after 48 to 72 hours. Physicians were blinded to NGAL and cystatin C levels. Type 1 cardio-renal syndrome was defined as an increase in the creatinine level of at least 0.3 mg/dl or 50% of basal creatinine.
RESULTS: Type 1 cardio-renal syndrome developed within 48 to 72 hours in 14 patients (11.8%). Admission NGAL levels were higher in these patients: 212 versus 83 ng/dl. At a cutoff value of 170 ng/L, NGAL determined type 1 cardio-renal syndrome with a sensitivity of 100% and a specificity of 86.7%. The area under the receiver-operating characteristic curve of NGAL was 0.93 and that of cystatin C was 0.68.
CONCLUSIONS: Above a cutoff value of 170 ng/L, NGAL predicts 48- to 72-hour development of type 1 cardio-renal syndrome with a negative predictive value of 100% and a positive predictive value of 50%. NGAL independently associates with type 1 cardio-renal syndrome and might be a useful biomarker in the early recognition of these patients.
Authors:
Margarida Alvelos; Rodrigo Pimentel; Elika Pinho; André Gomes; Patricia Lourenço; Maria José Teles; Pedro Almeida; João Tiago Guimarães; Paulo Bettencourt
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-29
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  6     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-17     Completed Date:  2011-06-30     Revised Date:  2012-03-01    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-81     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Hospital São João, Porto, Portugal. pbettfer@med.up.pt
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Acute-Phase Proteins
Aged
Aged, 80 and over
Biological Markers / blood
Chi-Square Distribution
Creatinine / blood
Cystatin C / blood
Early Diagnosis
Female
Glomerular Filtration Rate
Heart Failure / blood,  diagnosis*,  physiopathology
Humans
Kidney Diseases / blood,  diagnosis*,  physiopathology
Lipocalins / blood*
Logistic Models
Male
Middle Aged
Patients' Rooms*
Portugal
Predictive Value of Tests
Prognosis
Proto-Oncogene Proteins / blood*
ROC Curve
Risk Assessment
Risk Factors
Syndrome
Time Factors
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Acute-Phase Proteins; 0/Biological Markers; 0/CST3 protein, human; 0/Cystatin C; 0/LCN2 protein, human; 0/Lipocalins; 0/Proto-Oncogene Proteins; 60-27-5/Creatinine

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