Document Detail


Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease.
MedLine Citation:
PMID:  19176795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) has recently assumed epidemic proportion, becoming a troubling emerging cause of morbidity, especially if it progresses to terminal stage (ESRD). The authors aimed to evaluate whether neutrophil gelatinase-associated lipocalin (NGAL), a novel specific biomarker of acute kidney injury, could predict the progression of CKD.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Serum and urinary NGAL levels, together with a series of putative progression factors, were evaluated in a cohort of 96 patients (mean age: 57 +/- 16 years) affected by nonterminal CKD (eGFR > or =15 ml/min/1.73 m(2)) of various etiology. Progression of CKD, assessed as doubling of baseline serum creatinine and/or onset of ESRD, was evaluated during follow-up.
RESULTS: At baseline, both serum and urinary NGAL were inversely, independently, and closely related to eGFR. After a median follow-up of 18.5 mo (range 1.01 to 20), 31 patients (32%) reached the composite endpoint. At baseline, these patients were significantly older and showed increased serum creatinine, calcium-phosphate product, C-reactive protein, fibrinogen, daily proteinuria, and NGAL levels, whereas eGFR values were significantly lower. Univariate followed by multivariate Cox proportional hazard regression analysis showed that urinary NGAL and sNGAL predicted CKD progression independently of other potential confounders, including eGFR and age.
CONCLUSION: In patients with CKD, NGAL closely reflects the entity of renal impairment and represents a strong and independent risk marker for progression of CKD.
Authors:
Davide Bolignano; Antonio Lacquaniti; Giuseppe Coppolino; Valentina Donato; Susanna Campo; Maria Rosaria Fazio; Giacomo Nicocia; Michele Buemi
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Publication Detail:
Type:  Journal Article     Date:  2009-01-28
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  4     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-16     Completed Date:  2009-06-11     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  337-44     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Messina, Messima, Italy.
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MeSH Terms
Descriptor/Qualifier:
Acute-Phase Proteins / urine*
Adult
Aged
Biological Markers / blood,  urine
Chronic Disease
Creatinine / blood
Disease Progression
Female
Glomerular Filtration Rate
Humans
Kaplan-Meier Estimate
Kidney Diseases / complications,  metabolism*,  physiopathology
Kidney Failure, Chronic / blood,  etiology*,  physiopathology
Lipocalins / blood*,  urine*
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Proto-Oncogene Proteins / blood*,  urine*
ROC Curve
Risk Assessment
Risk Factors
Chemical
Reg. No./Substance:
0/Acute-Phase Proteins; 0/Biological Markers; 0/LCN2 protein, human; 0/Lipocalins; 0/Proto-Oncogene Proteins; 60-27-5/Creatinine
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