Diagnostic relevance of neutrophil gelatinase-associated lipocalin in early detection of acute kidney injury

Objective: To evaluate the predictive and diagnostic accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in acute kidney injury (AKI) and also to predict the renal replacement therapy (RRT) using NGAL as a marker.Methods: This prospective study was conducted among the patients admitted to intensive care units. Plasma samples were collected ۲۴ hours after admission and NGAL was measured using Triage® NGAL test, a specific point of care test which is based on the mechanism of fluorescence immunoassay. The diagnostic accuracy of plasma NGAL (pNGAL) to predict AKI in critically ill patients of ICU was assessed by applying receiver operator curve (ROC) analysis and calculating the area under the curve (AUC).Results: In this study, ۱۰۰ patients with the mean age of ۴۹.۵۶ ± ۱۹.۲ years were included for the period of ۱۸ months. The blood samples were withdrawn from the patients ۲۴ and ۴۴ hours after admission. Totally, ۵۵% (n = ۵۵) of ICU patients were diagnosed with AKI. Plasma NGAL level was significantly increased in AKI patients as compared to non-AKI patients (۷۴۲.۶۵ ± ۷۳۴.۷۲ vs. ۲۵۵.۶۲ ± ۴۴۰.۰۹ μg/L; P < ۰.۰۱). The sensitivity and specificity of NGAL for diagnosing AKI was ۸۳.۶% and ۸۸.۹%, respectively. The overall diagnostic accuracy was ۸۶%. Diagnostic accuracy of NGAL for requirement of RRT was ۵۱%.Conclusion: Plasma NGAL is a reliable marker for patients with AKI in ICU, in case the cause of kidney injury is not known. In addition, NGAL also predicts the RRT need based on AKI severity.

کلیدواژه ها:

Neutrophil gelatinase-associated Lipocalin ، Acute kidney injury ، Renal replacement therapy