Calprotectin and neutrophil gelatinase–associated lipocalin in the differentiation of pre‐renal and intrinsic acute kidney injury

Seibert, Felix S.; Pagonas, Nikolaos; Arndt, R; Heller, Frank; Dragun, Duska; Persson, Pontus B.; Schmidt‐Ott, Kai M.; Zidek, Walter; Westhoff, Timm H.

doi:10.1111/apha.12064

Cited by 59 publications

(70 citation statements)

References 24 publications

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“…Both AKI and APN are characterized by acute, mostly tubulointerstitial kidney damage, although the damage is diffuse in AKI and limited to a section of the renal (30). In adult patients with established AKI, uNGAL levels have been reported to effectively differentiate between prerenal and intrinsic AKI (7). Likewise, we found in a previous study that urine and plasma NGAL levels could differentiate APN from a lower UTI in children with febrile UTIs (AUC-ROC 0.78 and 0.748, respectively) (18,19).…”

Section: Discussionmentioning

confidence: 99%

“…It has been identified as one of the earliest and potentially one of the most indicative biomarkers of acute kidney injury (AKI) from a diverse array of conditions and can differentiate between prerenal and intrinsic causes (6,7). Urinary NGAL (uNGAL) levels increase in patients with different causes of nephropathies (8,9) and might be a valuable tool in monitoring the treatment response of various renal diseases (10,11).…”

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Plasma neutrophil gelatinase-associated lipocalin predicts acute pyelonephritis in children with urinary tract infections

et al. 2015

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Background:The identification of acute pyelonephritis (APN) is still a challenge. Methods: Patients admitted for their first urinary tract infection (UTI) were enrolled. Plasma neutrophil gelatinaseassociated lipocalin (NGAL) levels were measured at admittance and after treatment. Laboratory, clinical, and imaging results were compared between children with and without APN. results: A total of 123 patients were enrolled (53 APN and 70 lower UTI). After adjusting for age and gender, plasma NGAL levels were higher in the APN group than in the lower UTI group (233 (129-496) ng/ml vs. 71 (50.8-110) ng/ml, P < 0.001). NGAL levels were correlated with the serum levels of leukocytes, C-reactive protein, and creatinine, as well as fever duration (P < 0.05). Multivariable analysis revealed that logtransformed plasma NGAL was an independent predictor of APN (P < 0.05). Receiver operating curve analysis showed a good diagnostic profile of NGAL for identifying APN (area under the curve 0.864) with a best cut-off value of 102.5 ng/ml. The NGAL levels in both two groups decreased after treatment compared to levels before treatment (P < 0.001). conclusion: Plasma NGAL can be a sensitive predictor for identifying APN and monitoring the treatment response of pediatric UTI. u rinary tract infections (UTIs) are among the most common bacterial infections in children (1). Early detection and proper management of UTIs is important since UTIs involving the kidney may cause permanent renal scarring and be a risk factor for future development of renal insufficiency (2). Establishing the diagnosis of acute pyelonephritis (APN) requires imaging with 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy to view renal parenchymal involvement (3). Although a DMSA scan is considered to be very sensitive in the assessment of renal damage, it is expensive, not readily available in all centers, and exposes the patients to radiation (4). Therefore, a more practical and accessible tool to determine the presence of renal parenchymal involvement could be helpful for the timely management of UTIs.Neutrophil gelatinase-associated lipocalin (NGAL), as a member of the lipocalin superfamily, is produced from the nephron in response to tubular epithelial damage (5). It has been identified as one of the earliest and potentially one of the most indicative biomarkers of acute kidney injury (AKI) from a diverse array of conditions and can differentiate between prerenal and intrinsic causes (6,7). Urinary NGAL (uNGAL) levels increase in patients with different causes of nephropathies (8,9) and might be a valuable tool in monitoring the treatment response of various renal diseases (10,11).As an iron-carrier protein derived from human neutrophils, NGAL also plays an important role in the innate immune response to bacterial infection (12). Experimentally, NGAL was capable of blocking Escherichia coli growth under ironpoor conditions, but NGAL with siderophore iron was not (13). NGAL-knockout mice demonstrated substantially increased mortality after intraperitoneal i...

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Section: Discussionmentioning

confidence: 99%

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Plasma neutrophil gelatinase-associated lipocalin predicts acute pyelonephritis in children with urinary tract infections

et al. 2015

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“…7 It has been identified as one of the earliest and potentially one of the most indicative biomarkers of AKI from a diverse array of conditions and can differentiate between prerenal and intrinsic causes. 8,9 Downstream proteomic analysis also revealed NGAL to be one of the most highly induced protein in the kidney after ischemic or nephrotoxic AKI in animal models and studies implicated NGAL as an early diagnostic biomarker for AKI in common clinical situations. 10 Because of the limitations regarding use of SCr for the early detection of AKI, and the importance of early detection, this study is being taken up to know the role of serum NGAL that would allow earlier detection of AKI.…”

Section: Introductionmentioning

confidence: 99%

Serum neutrophil gelatinase-associated lipocalin as an early biomarker of acute kidney injury in subjects undergoing percutaneous transluminal coronary angiogram with normal EGFR

Sonagra¹,

Makandar²,

Patnaik³

et al. 2020

IJCBR

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Introduction: Detecting AKI in a timely fashion with the current AKIN staging criteria is a challenge because the diagnosis of AKI is usually based on changes in serum creatinine (SCr) which is a poor marker of early renal dysfunction. Aim: To study the role of Serum Neutrophil Gelatinase-Associated Lipocalcin (NGAL) as early biomarker for the detection of Contrast induced acute kidney injury (CIAKI) in subjects undergoing Percutaneous transluminal coronary angiogram (PTCA) with normal eGFR. Materials and Methods: Prospective cohort study was conducted, where SCr and serum NGAL were serially measured in a heterogeneous group of subjects (n=60) presenting to cardiology department. Results: The study population consisted of 60 subjects. All subjects were divided into 2 groups "CIAKI group" and "no-CIAKI group" according to predefined definition. The serum NGAL increased and reached its peak at 4 hours after contrast media (CM) administration and did not returned to baseline by 24 hours while the SCr increased at 24 hours and reached peak at 48 hours respectively (P<0.001).Thus, 4 hours after CM administration were considered to be appropriate time point for NGAL measurement and there was no significant correlation between serum NGAL with SCr at 0 hours, 4hours, 24 hours and 48hours. Conclusion: In our study, we found that serum NGAL promises to be a simple, safe, non-invasive and reliable early biomarker for predicting possible onset of CIAKI following contrast administration.

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“…There are few studies conducted in cisplatin induced ischemic kidney in rat and adult that show calprotectin could differentiate between pre-renal and ischemic acute kidney injury (20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Urinary Calprotectin as a Marker to Distinguish Functional and Structural Acute Kidney Injury in Pediatric Population

et al. 2017

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Background: Acute kidney injury (AKI) is a serious, common and occasionally under-recognized condition. To date, the clinical and some laboratory parameters are routinely applied to distinguish between functional and structural AKI which can be challenging in certain occasions. In the present paper, we investigate the accuracy of urinary calprotectin as a diagnostic biomarker in this dubious situation.

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Calprotectin and neutrophil gelatinase–associated lipocalin in the differentiation of pre‐renal and intrinsic acute kidney injury

Abstract: This study shows that both calprotectin and NGAL are able to differentiate between pre-renal and intrinsic AKI after exclusion of pyuria. In the present population, calprotectin presents a higher sensitivity and specificity than NGAL.

Cited by 59 publications

References 24 publications

Plasma neutrophil gelatinase-associated lipocalin predicts acute pyelonephritis in children with urinary tract infections

Plasma neutrophil gelatinase-associated lipocalin predicts acute pyelonephritis in children with urinary tract infections

Serum neutrophil gelatinase-associated lipocalin as an early biomarker of acute kidney injury in subjects undergoing percutaneous transluminal coronary angiogram with normal EGFR

Urinary Calprotectin as a Marker to Distinguish Functional and Structural Acute Kidney Injury in Pediatric Population

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