Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
Aim: Sepsis is the leading cause of ICU admission. Plasma NGAL is a promising biomarker for AKI detection, however it is also increased with inflammation and few studies have been conducted in non-caucasion populations and/or in developing economies. Therefore, we evaluated plasma NGAL’s diagnost...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English English English English |
| Published: |
Asian Pacific Society of Nephrology
2017
|
| Subjects: | |
| Online Access: | http://irep.iium.edu.my/50448/ http://irep.iium.edu.my/50448/ http://irep.iium.edu.my/50448/1/50448_-_Plasma_Neutrophil_Gelatinase_Associated_Lipocalin_Diagnosed.pdf http://irep.iium.edu.my/50448/4/50448-Plasma%20Neutrophil%20Gelatinase-Associated%20Lipocalin%20diagnosed_MYRA%20evidence.pdf http://irep.iium.edu.my/50448/5/50448-Plasma%20Neutrophil%20Gelatinase-Associated%20Lipocalin%20diagnosed_SCOPUS.pdf http://irep.iium.edu.my/50448/6/50448-Plasma%20Neutrophil%20Gelatinase-Associated%20Lipocalin%20diagnosed_WOS.pdf |
| Summary: | Aim: Sepsis is the leading cause of ICU admission. Plasma NGAL is a promising biomarker for AKI
detection, however it is also increased with inflammation and few studies have been conducted
in non-caucasion populations and/or in developing economies. Therefore, we evaluated plasma
NGAL’s diagnostic performance in the presence of sepsis and systemic inflammatory response
syndrome (SIRS) in a Malaysian ICU cohort.
Methods: This is a prospective observational study on patients with SIRS. Plasma creatinine
(pCr) and NGAL were measured on ICU admission. Patients were classified according to the
occurrence of AKI and sepsis.
Results: Of 225 patients recruited, 129 (57%) had sepsis of whom 67 (52%) also had AKI. 96
patients (43%) had non-infectious SIRS, of whom 36 (21%) also had AKI. NGAL concentrations
were higher in AKI patients within both the sepsis and non-infectious SIRS cohorts (both
p<0.0001). The diagnostic area under curve for AKI was 0.81 (95%CI: 0.74 to 0.87). The optimal
cut-off was higher in sepsis compared to non-infectious SIRS patients (454 versus 176 ng/ml).
Addition of NGAL to a clinical model comprising age, pCr, medical admission category and SAPS
II score increased the mean risk of those with AKI by 4% and reduced the mean risk of those
without AKI by 3%.
Conclusions: AKI is more common with sepsis than non-infectious SIRS. Plasma NGAL was
diagnostic of AKI in both subgroups. The optimal cut-off for diagnosing AKI was higher in sepsis
Nephrology
than in non-infectious SIRS. Addition of plasma NGAL improved the clinical model used to
diagnose AKI |
|---|