Serum Neutrophil Gelatinase-Associated Lipocalin as a Marker of Renal Function in Non-Diabetic Patients with Stage 2–4 Chronic Kidney Disease

Abstract

The current Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines advocate creatinine-based equations for estimating GFR to identify patients with potential kidney disease and classify them into different stages due to the fact that serum creatinine is very insensitive to changes in the glomerular filtration rate. Very few biomarkers exist for monitoring chronic kidney disease. The aim of the study was to assess whether NGAL could represent a novel, sensitive marker of kidney function in adult patients with CKD. The study was performed on 92 nondiabetic patients with CKD stages 2-4. Serum and urinary NGAL as well as serum cystatin C were measured using commercially available kits. Serum NGAL was related, in univariate analysis, to serum creatinine, urinary NGAL, hemoglobin, hematocrit, leukocyte count, eGFR, and cystatin C. Urinary NGAL correlated with age, hemoglobin, hematocrit, serum creatinine, and eGFR. In multiple regression analysis, predictors of serum NGAL were creatinine (beta value = 0.97, p = 0.005), cystatin C (beta = 0.34, p = 0.01), and eGFR (beta value = 1.77, p = 0.001). In the healthy volunteers, serum NGAL correlated with age, serum creatinine, eGFR, leukocyte count, and cystatin C. Taking into consideration the fact that the recent DOQI (Dialysis Outcomes Quality Initiative) states that individuals with reduced GRF (glomerular filtration rate) are at greater risk for CVD and cardiac deaths, precise evaluation of renal function is important in order to select the appropriate strategy to reduce the cardiovascular risk. NGAL should be investigated as a potential early and sensitive marker of kidney impairment/injury.

SERUM NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AS A PREDICTIVE BIOMARKER OF KIDNEY INJURY IN RENAL TRANSPLANTED PATIENTS and CHRONIC KIDNEY DISEASE

“…In the present study the higher NGAL level, and the correlations between NGAL and other kidney parameters were studied (results and fig. 1-6) and are in agreement with many reports, which implies that NGAL is an early indicator biomarker for both RT and advanced CKD patients and can be used to start early treatment in these patients [39][40][41][42]. Malyszko et al in their study showed that in patients with delayed graft function; there was no fall in serum NGAL or cystatin-c.…”

Using NGAL as an Early Diagnostic Test of Acute Kidney Injury

“…It was further postulated that sNGAL and urine NGAL (uNGAL) may be useful as sensitive markers of kidney impairment/injury in CKD patients. 15 …”

Possible Relationship between Neutrophil Gelatinase-Associated Lipocalin, Hepcidin, and Inflammation in Haemodialysed Patients

“…We also found additional univariate correlations (serum creatinine, urea, urea reduction ratio, and also with other markers of inflammation). As demonstrated previously, NGAL correlated with kidney function in kidney allograft recipients and patients with chronic kidney disease [29,30]. Therefore, the presence or absence of residual renal function may affect NGAL levels significantly.…”