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...

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Main Authors:	Md Ralib, Azrina, Mat Nor, Mohd Basri, Pickering, John W.
Format:	Article
Language:	English English English English
Published:	Asian Pacific Society of Nephrology 2017
Subjects:	R Medicine (General)
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

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spelling	iium-504482018-01-10T08:39:43Z http://irep.iium.edu.my/50448/ Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis Md Ralib, Azrina Mat Nor, Mohd Basri Pickering, John W. R Medicine (General) 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 Asian Pacific Society of Nephrology 2017-05 Article PeerReviewed application/pdf en http://irep.iium.edu.my/50448/1/50448_-_Plasma_Neutrophil_Gelatinase_Associated_Lipocalin_Diagnosed.pdf application/pdf en http://irep.iium.edu.my/50448/4/50448-Plasma%20Neutrophil%20Gelatinase-Associated%20Lipocalin%20diagnosed_MYRA%20evidence.pdf application/pdf en http://irep.iium.edu.my/50448/5/50448-Plasma%20Neutrophil%20Gelatinase-Associated%20Lipocalin%20diagnosed_SCOPUS.pdf application/pdf en http://irep.iium.edu.my/50448/6/50448-Plasma%20Neutrophil%20Gelatinase-Associated%20Lipocalin%20diagnosed_WOS.pdf Md Ralib, Azrina and Mat Nor, Mohd Basri and Pickering, John W. (2017) Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis. Nephrology, 22 (5). pp. 412-419. E-ISSN 1440-1797 http://onlinelibrary.wiley.com/doi/10.1111/nep.12796/full
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Md Ralib, Azrina Mat Nor, Mohd Basri Pickering, John W. Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
description	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
format	Article
author	Md Ralib, Azrina Mat Nor, Mohd Basri Pickering, John W.
author_facet	Md Ralib, Azrina Mat Nor, Mohd Basri Pickering, John W.
author_sort	Md Ralib, Azrina
title	Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
title_short	Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
title_full	Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
title_fullStr	Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
title_full_unstemmed	Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
title_sort	plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis
publisher	Asian Pacific Society of Nephrology
publishDate	2017
url	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
first_indexed	2023-09-18T21:11:18Z
last_indexed	2023-09-18T21:11:18Z
_version_	1777411271116718080

Plasma neutrophil gelatinase associated lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis

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