| Neutrophil gelatinase-associated lipocalin in the diagnosis of type 1 cardio-renal syndrome in the general ward. | |
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MedLine Citation:
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PMID: 21115620 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Margarida Alvelos; Rodrigo Pimentel; Elika Pinho; André Gomes; Patricia Lourenço; Maria José Teles; Pedro Almeida; João Tiago Guimarães; Paulo Bettencourt |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-11-29 |
Journal Detail:
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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:
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Created Date: 2011-03-17 Completed Date: 2011-06-30 Revised Date: 2012-03-01 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 476-81 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Hospital São João, Porto, Portugal. pbettfer@med.up.pt |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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