| Urinary neutrophil gelatinase-associated lipocalin distinguishes pre-renal from intrinsic renal failure and predicts outcomes. | |
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MedLine Citation:
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PMID: 21412214 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In established acute kidney injury (AKI), serum creatinine poorly differentiates prerenal from intrinsic AKI. In this study, we tested whether urinary neutrophil gelatinase-associated lipocalin (NGAL) distinguishes between intrinsic and prerenal AKI, and tested its performance in predicting a composite outcome that included progression to a higher RIFLE (Risk, Injury, Failure, Loss of function, End stage renal disease) class, dialysis, or death. Urinary NGAL was measured using a standardized clinical platform in 161 hospitalized patients with established AKI. Sixteen patients were excluded because of postrenal obstruction or insufficient clinical information. Of the remaining 145 patients, 75 had intrinsic AKI, 32 had prerenal AKI, and 38 patients could not be classified. Urinary NGAL levels effectively discriminated between intrinsic and prerenal AKI (area under the receiver-operating characteristic curve 0.87). An NGAL level over 104 μg/l indicated intrinsic AKI (likelihood ratio 5.97), whereas an NGAL level <47 μg/l made intrinsic AKI unlikely (likelihood ratio 0.2). Patients experiencing the composite outcome had significantly higher median urinary NGAL levels on inclusion. In logistic regression analysis, NGAL independently predicted the composite outcome when corrected for demographics, comorbidities, creatinine, and RIFLE class. Hence, urinary NGAL is useful in classifying and stratifying patients with established AKI. |
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Authors:
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Eugenia Singer; Antje Elger; Saban Elitok; Ralph Kettritz; Thomas L Nickolas; Jonathan Barasch; Friedrich C Luft; Kai M Schmidt-Ott |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-03-16 |
Journal Detail:
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Title: Kidney international Volume: 80 ISSN: 1523-1755 ISO Abbreviation: Kidney Int. Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-07-29 Completed Date: 2011-12-07 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: United States |
Other Details:
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Languages: eng Pagination: 405-14 Citation Subset: IM |
Affiliation:
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Experimental and Clinical Research Center, a joint institution of the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Kidney Injury
/
complications,
diagnosis,
mortality,
therapy,
urine* Acute-Phase Proteins / urine* Aged Aged, 80 and over Biological Markers / blood, urine Chi-Square Distribution Creatinine / blood Diagnosis, Differential Disease Progression Female Hospital Mortality Hospitalization Humans Kidney Failure, Chronic / etiology, mortality, therapy, urine Lipocalins / urine* Logistic Models Male Middle Aged Odds Ratio Predictive Value of Tests Proto-Oncogene Proteins / urine* ROC Curve Renal Insufficiency / etiology, mortality, therapy, urine Renal Replacement Therapy Risk Assessment Risk Factors Severity of Illness Index Time Factors Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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K23 DK080139/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Acute-Phase Proteins; 0/Biological Markers; 0/LCN2 protein, human; 0/Lipocalins; 0/Proto-Oncogene Proteins; 60-27-5/Creatinine |
| Comments/Corrections | |
Comment In:
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Kidney Int. 2011 Aug;80(4):332-4
[PMID:
21799504
]
Kidney Int. 2012 Feb;81(3):321; author reply 321-2 [PMID: 22241560 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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