Prognostic Value of Levels of Urine Neutrophil Gelatinase-associated Lipocalin and Interleukin-18 in Patients With Delayed Graft Function After Kidney Transplantation

Cui, Liyan; Zhu, Xiaoyan; Yang, Shuo; Zhou, Jidong; Zhang, H.-X.; Liu, L.; Zhang, J.

doi:10.1016/j.transproceed.2015.10.042

Cited by 17 publications

(13 citation statements)

References 16 publications

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“…These findings let us speculate that NGAL is not only a marker of tubular damage but also a filtration marker, but this requires further investigation. NGAL was tracked in both serum and urine compared to several other studies describing only urinary NGAL expression [ 12 , 23 , 27 – 29 ]. In multivariate analyses we could show, that urinary NGAL as well as serum NGAL can significantly predict DGF on the second postoperative day but not creatinine.…”

Section: Discussionmentioning

confidence: 99%

Prediction of delayed graft function and long-term graft survival by serum and urinary neutrophil gelatinase–associated lipocalin during the early postoperative phase after kidney transplantation

et al. 2018

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Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as an early marker protein for kidney dysfunction in various clinical settings. In this prospective study we evaluated serial changes of serum and urinary NGAL within the first 7 days after kidney transplantation in 170 consecutive recipients. The main focus of this study was to assess the performance of serum and urinary NGAL in the prediction of delayed graft function (DGF) and two-year graft and patient survival. Serum and urine samples of 170 patients undergoing primary kidney transplantation from October 2010 to December 2012 were prospectively collected from day 0 to 7. NGAL was analyzed by ELISA. Multivariate regression models, receiver-operating characteristics (ROC), and areas under ROC curves (AUC) were used to identify predictors of DGF. DGF occurred in 52 patients (30.6%). Serum (AUC = 0.869) and urinary NGAL (AUC = 0.872) on postoperative day (POD) 2 could accurately predict DGF compared to serum creatinine (AUC = 0.619). Multivariate analyses revealed donor age, serum and urinary NGAL significantly associated with DGF (p<0.001). Recipient age was the only significant factor in a cox regression model influencing two-year graft and patient survival. In conclusion, serum and urinary NGAL are early predictors of DGF after kidney transplantation.

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Section: Discussionmentioning

confidence: 99%

Prediction of delayed graft function and long-term graft survival by serum and urinary neutrophil gelatinase–associated lipocalin during the early postoperative phase after kidney transplantation

et al. 2018

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“…Which one between uNGAL or pNGAL might represent the best biomarker for graft outcome remains an open issue. In Table 1, we have summarized the main published studies performed in renal transplant recipients, where the predictivity of uNGAL and pNGAL in terms of cut-off levels, sensitivity and specificity were available (34,36,38,(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52).…”

Section: Plasma Ngal and Dgfmentioning

confidence: 99%

Neutrophil Gelatinase‐Associated Lipocalin as a Biomarker of Allograft Function After Renal Transplantation: Evaluation of the Current Status and Future Insights

et al. 2017

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Neutrophil gelatinase‐associated lipocalin (NGAL), a protein belonging to the lipocalin superfamily initially found in activated neutrophils, is expressed by several cell types, including kidney tubule. The increase in NGAL production and release from tubular cells in response to various insults has been proven to predict acute kidney injury (AKI). For this reason, it has emerged as a valuable noninvasive biomarker of AKI in clinical nephrology. Also in the renal transplant setting, different studies have indicated NGAL as a valuable tool, especially in the early postoperative period, since the currently available clinical and laboratory parameters remain poorly sensitive to monitor immediate posttransplant graft function. This is an analysis of the recent literature to assess the utility of plasma and urinary NGAL, exosomal mRNA for NGAL, and NGAL levels in the perfusate of machine‐perfused kidneys for the prediction of graft function recovery in the early postsurgery phase after renal transplantation. We found that NGAL appears as a promising troponin‐like biomarker to detect short‐term impairment of graft function after renal transplant, but there are still some limitations in its clinical application, essentially related to its low specificity. Moreover, comparing NGAL assayed in serum, urine, machine‐perfusate, or as exosomal mRNA, each one has shown limitations and benefits in terms of predictive performance for DGF, according to various existing studies, feasibly due to different cut‐off levels, designs and patient sample sizes.

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“…Males represented 61.4% of the study population. 9 studies defined DGF as the requirement for dialysis within 7 days after transplantation, 4 studies [13, 17–19] combined the dialysis-based criterion and the failure of Scr to decrease or the graft histopathology criterion to define DGF and pezeshgi’s study [20] did not describe the detailed definition of DGF. No significant differences were observed between 8 uNGAL studies and 6 bNGAL studies in terms of DCD or ECD ratio, donor age, donor Scr and CIT ( P > 0.05).…”

Section: Resultsmentioning

confidence: 99%

Comparison of urine and blood NGAL for early prediction of delayed graft function in adult kidney transplant recipients: a meta-analysis of observational studies

Lin

et al. 2019

BMC Nephrol

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Background Neutrophil gelatinase-assoicated lipocalin (NGAL) appears to be a promising proximal tubular injury biomarker for early prediction of delayed graft function (DGF) in kidney transplant recipients. However, its predictive values in urine and blood were varied among different studies. Here, we performed the meta-analysis to compare the predictive values of urine NGAL (uNGAL) and blood NGAL (bNGAL) for DGF in adult kidney transplant recipients. Methods We systematically searched Medline, Cochrane library and Embase for relevant studies from inception to May 2018. The summary receiver operating characteristic (SROC) curves, the pooled sensitivity, specificity and diagnostic odds ratio (DOR) were used to evaluate the prognostic performance of uNGAL and bNGAL for the identification of DGF. Results A total of 1036 patients from 14 eligible studies were included in the analysis. 8 studies focused on NGAL in urine and 6 reported NGAL in serum or plasma. The composite area under the ROC (AUC) for 24 h uNGAL was 0.91 (95% CI, 0.89–0.94) and the overall DOR for 24 h uNGAL was 24.17(95% CI, 9.94–58.75) with a sensitivity of 0.88 (95% CI, 0.75–0.94) and a specificity of 0.81 (95% CI, 0.68–0.89). The composite AUC for 24 h bNGAL was 0.95 (95% CI, 0.93–0.97) and the overall DOR for 24 h bNGAL was 43.11 (95% CI, 16.43–113.12) with a sensitivity of 0.91 (95% CI, 0.81–0.96) and a specificity of 0.86 (95% CI, 0.78–0.92). Conclusions Urine and serum/plasma NGAL were valuable biomarkers for early identification of DGF in kidney transplantation. In addition, the bNGAL was superior to uNGAL in early prediction of DGF. Electronic supplementary material The online version of this article (10.1186/s12882-019-1491-y) contains supplementary material, which is available to authorized users.

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Prognostic Value of Levels of Urine Neutrophil Gelatinase-associated Lipocalin and Interleukin-18 in Patients With Delayed Graft Function After Kidney Transplantation

Cited by 17 publications

References 16 publications

Prediction of delayed graft function and long-term graft survival by serum and urinary neutrophil gelatinase–associated lipocalin during the early postoperative phase after kidney transplantation

Prediction of delayed graft function and long-term graft survival by serum and urinary neutrophil gelatinase–associated lipocalin during the early postoperative phase after kidney transplantation

Neutrophil Gelatinase‐Associated Lipocalin as a Biomarker of Allograft Function After Renal Transplantation: Evaluation of the Current Status and Future Insights

Comparison of urine and blood NGAL for early prediction of delayed graft function in adult kidney transplant recipients: a meta-analysis of observational studies

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