J Korean Soc Emerg Med.  2013 Apr;24(2):157-163.

Plasma Neutrophil Gelatinase-associated Lipocalin is an Early Marker of Acute Kidney Injury

• Lee JY
• Kim JY
• Park SO
• Lee KR
• Baek KJ
• Hong DY

Abstract

PURPOSE
Serum creatinine is a late marker of acute kidney injury (AKI). We assessed the diagnostic value of plasma neutrophil gelatinase-associated lipocalin (NGAL) for predicting acute kidney injury in emergency department patients with sepsis.
METHODS
This was a prospective observational study of adult sepsis patients. Plasma NGAL levels were measured upon admission to the hospital, and clinical data and serum creatinine were collected daily during the hospital stay. The primary outcome measure was the occurrence of AKI based on criteria from the Acute Kidney Injury Network (AKIN).
RESULTS
A total of 178 patients were included, with 13 patients (7.3%) that developed AKI during their hospital stay; 9 and 4 were classified as AKIN stage 1 and 2, respectively. Six patients out of the 13 with AKI died. Mean plasma NGAL levels were 277 ng/mL in patients without AKI and 852 ng/mL in patients with AKI. The area under the receiver operating characteristic curve was 0.883 (95% confidence interval 0.803 to 0.964), the sensitivity was 91.7%, and the specificity was 80.5% for the prediction of AKI (using a cut-off value of 353.5 ng/mL).
CONCLUSION
Plasma NGAL is a useful early marker that predicts the development of AKI in adult sepsis patients.

Keyword

Acute Kidney injury; Creatinine; Biological Markers

MeSH Terms

Acute Kidney Injury
Adult
Biomarkers
Creatinine
Emergencies
Humans
Length of Stay
Lipocalins
Neutrophils
Outcome Assessment (Health Care)
Plasma
Prospective Studies
ROC Curve
Sensitivity and Specificity
Sepsis
Creatinine
Lipocalins