|Urinary neutrophil gelatinase-associated lipocalin distinguishes pre-renal from intrinsic renal failure and predicts outcomes.|
|PMID: 21412214 Owner: NLM Status: MEDLINE|
|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.|
|Eugenia Singer; Antje Elger; Saban Elitok; Ralph Kettritz; Thomas L Nickolas; Jonathan Barasch; Friedrich C Luft; Kai M Schmidt-Ott|
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|Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-03-16|
|Title: Kidney international Volume: 80 ISSN: 1523-1755 ISO Abbreviation: Kidney Int. Publication Date: 2011 Aug|
|Created Date: 2011-07-29 Completed Date: 2011-12-07 Revised Date: 2013-04-15|
Medline Journal Info:
|Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: United States|
|Languages: eng Pagination: 405-14 Citation Subset: IM|
|Experimental and Clinical Research Center, a joint institution of the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany.|
|APA/MLA Format Download EndNote Download BibTex|
Acute Kidney Injury
Acute-Phase Proteins / urine*
Aged, 80 and over
Biological Markers / blood, urine
Creatinine / blood
Kidney Failure, Chronic / etiology, mortality, therapy, urine
Lipocalins / urine*
Predictive Value of Tests
Proto-Oncogene Proteins / urine*
Renal Insufficiency / etiology, mortality, therapy, urine
Renal Replacement Therapy
Severity of Illness Index
|K23 DK080139/DK/NIDDK NIH HHS; R01 DK073462/DK/NIDDK NIH HHS|
|0/Acute-Phase Proteins; 0/Biological Markers; 0/LCN2 protein, human; 0/Lipocalins; 0/Proto-Oncogene Proteins; 60-27-5/Creatinine|
Kidney Int. 2011 Aug;80(4):332-4
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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