Diabetes Metab J.  2012 Aug;36(4):307-313. 10.4093/dmj.2012.36.4.307.

Urinary Neutrophil Gelatinase-Associated Lipocalin Levels in Comparison with Glomerular Filtration Rate for Evaluation of Renal Function in Patients with Diabetic Chronic Kidney Disease

• Woo KS
• Choi JL
• Kim BR
• Kim JE
• An WS
• Han JY

• KMID: 2174431
• DOI: http://doi.org/10.4093/dmj.2012.36.4.307

Abstract

BACKGROUND
Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker of acute kidney injury. There is a growing body of evidence suggesting that NGAL is also a marker of kidney disease and severity in chronic kidney disease (CKD). We studied the utility of urinary NGAL in more accurately predicting renal function in patients with diabetic CKD.
METHODS
We studied possible relationships between urinary NGAL, estimated glomerular filtration rate (eGFR), and proteinuria in diabetic CKD patients and in healthy populations.
RESULTS
Urinary NGAL levels were significantly higher in CKD patients than in healthy controls (96.0 [2.7 to 975.2] ng/mL vs. 18.8 [1.3 to 81.9] ng/mL, P=0.02), and the GFR was lower among CKD patients (49.3 [13.1 to 78.3] mL/min/1.73 m2 vs. 85.6 [72 to 106.7] mL/min/1.73 m2, P<0.0001). The urinary NGAL level showed a significant inverse correlation with GFR (r=-0.5634, P<0.0001). The correlation analyses between urinary protein level and urinary NGAL levels and GFR were as follows: urine protein and urinary NGAL (r=0.3009, P=0.0256), urine protein and GFR (r=-0.6245, P<0.0001), urine microalbumin and urinary NGAL (r=0.1794, P=0.2275), and urine microalbumin and GFR (r=-0.5190, P=0.0002).
CONCLUSION
From these results, we concluded that urinary NGAL is a reliable marker of renal function in diabetic CKD patients. However, urinary NGAL did not provide more accurate information regarding renal function than GFR.

Keyword

Chronic kidney disease; Glomerular filtration rate; Neutrophil gelatinase-associated lipocalin

MeSH Terms

Acute Kidney Injury
Glomerular Filtration Rate
Humans
Kidney Diseases
Lipocalins
Neutrophils
Proteinuria
Renal Insufficiency, Chronic
Lipocalins

Figure

• 

  Fig. 1 Urinary neutrophil gelatinase-associated lipocalin (NGAL) levels and glomerular filtration rate (GFR) in patients and healthy populations. (A) NGAL levels: 18.8 (1.3 to 81.9) ng/mL vs. 96.0 (2.7 to 975.2) ng/mL (P=0.02). (B) GFR: 49.3 (13.1 to 78.3) mL/min/1.73 m2 vs. 85.6 (72 to 106.7) mL/min/1.73 m2 (P<0.0001). CKD, chronic kidney disease.

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  Fig. 2 Correlation analysis between glomerular filtration rate (GFR) and urinary neutrophil gelatinase-associated lipocalin (NGAL) in chronic kidney disease patients (r=-0.5634, P<0.0001).

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  Fig. 3 Correlation analyses for urine protein and urinary neutrophil gelatinase-associated lipocalin (NGAL) levels and glomerular filtration rate (GFR) in chronic kidney disease patients. Correlations were analyzed between urinary protein level and urinary NGAL level (A) (r=0.3009, P=0.0256), urine protein and GFR (B) (r=-0.6245, P<0.0001), urine albumin and urinary NGAL (C) (r=0.1794, P=0.2275), and urine albumin and GFR (D) (r=-0.5190, P=0.0002).

• 

  Fig. 4 Correlation between age (A) (r=-0.1488, P=0.3866), sex (B) (P=0.1823), and glomerular filtration rate (GFR) (C) (r=-0.2621, P=0.1226) and urinary neutrophil gelatinase-associated lipocalin (NGAL) in healthy populations.

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