The clinical significance of neutrophil gelatinase‐associated lipocalin in ischemic stroke patients with acute kidney injury

Xiao, Wei; Chen, Wei; Hu, Hongping; Huang, Xiaomei; Luo, Yi

doi:10.1002/jcla.22907

Cited by 9 publications

(9 citation statements)

References 28 publications

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“…A previous study reported that urinary liver-type fatty-acid binding protein (L-FABP) was independently associated with the development of AKI and 90-day mortality in critically ill patients with IS ( 6 ). Xiao et al found that serum neutrophil gelatinase-associated lipocalin (NGAL) could predict AKI in patients with IS ( 7 ). However, the above-mentioned biomarkers are not easy to obtain in the ICU setting, and finding relatively clinically often-used indicators may help ICU clinicians in identifying those at high risk.…”

Section: Introductionmentioning

confidence: 99%

A novel risk model based on white blood cell-related biomarkers for acute kidney injury prediction in patients with ischemic stroke admitted to the intensive care unit

Liu

Yang³

et al. 2022

Front. Med.

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BackgroundConventional systemic inflammatory biomarkers could predict prognosis in patients with ischemic stroke (IS) admitted to the intensive care unit (ICU). Acute kidney injury (AKI) is common in patients with IS admitted to ICU, but few studies have used systemic inflammatory biomarkers to predict AKI in critically ill patients with IS. This study aimed to establish a risk model based on white blood cell (WBC)-related biomarkers to predict AKI in critically ill patients with IS.MethodsData were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) for a training cohort, and data were extracted from the Medical Information Mart for eICU Collaborative Research Database (eICU-CRD) for a validation cohort. Logistic regression analysis was used to determine the significant predictors of WBC-related biomarkers on AKI prediction, and a risk model was established based on those significant indicators in multivariate logistic regression. The receiver operating characteristics (ROC) curve was utilized to obtain the best cut-off value of the risk model. The Kaplan–Meier curve was used to evaluate the prognosis-predictive ability of the risk model.ResultsThe overall incidence of AKI was 28.4% in the training cohort and 33.2% in the validation cohort. WBC to lymphocyte ratio (WLR), WBC to basophils ratio (WBR), WBC to hemoglobin ratio (WHR), and neutrophil to lymphocyte ratio (NLR) could independently predict AKI, and a novel risk model was established based on WLR, WBR, WHR, and NLR. This risk model depicted good prediction performance both in AKI and other clinical outcomes including hemorrhage, persistent AKI, AKI progression, ICU mortality, and in-hospital mortality both in the training set and in the validation set.ConclusionA risk model based on WBC-related indicators exhibited good AKI prediction performance in critically ill patients with IS which could provide a risk stratification tool for clinicians in the ICU.

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Section: Introductionmentioning

confidence: 99%

A novel risk model based on white blood cell-related biomarkers for acute kidney injury prediction in patients with ischemic stroke admitted to the intensive care unit

Liu

Yang³

et al. 2022

Front. Med.

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“…NGAL has been accepted by many nephrologists as a biomarker of early acute and chronic kidney injury, and some scholars also regard it as a neuroin ammatory marker [15,16,32]. This study found that the level of NGAL in IS patients was higher than that of HC and DC, while the levels of the other four renal function markers were only higher than HC.…”

Section: Discussionmentioning

confidence: 66%

“…In addition, its serum level gradually increases with the continuous progress of CKD [14]. Many studies have found that NGAL can also be used as a marker of neuroin ammation and related behavioral dysfunction [15,16]. The increase of NGAL in brain tissue can aggravate amyloid-β-induced toxicity, leading to neurodegenerative changes in the brainstem nucleus [17].…”

Section: Introductionmentioning

confidence: 99%

Differential Performance of Neutrophil Gelatinase-Associated Lipocalin and Cystatin C to Predict Ischemic Stroke

Peng

Chen

et al. 2021

Preprint

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Objective Both cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL) are markers of kidney injury and may also be marker candidates for neuroinflammation. The aim of this article is to explore the relationship between kidney injury and ischemic stroke (IS).Methods 498 IS patients were enrolled, and 173 IS-related disease control (DC) patients and 293 healthy control (HC) subjects were randomly selected. We analyzed the relationship between the levels of serum kidney function markers (including NGAL, Cre, Ure, CysC and eGFR) and the occurrence of IS.Results When they were admitted to the hospital, the NGAL level of patients with first-onset IS was higher than that of both HC group (z=5.964, P<0.001) and DC (z=12.191, P<0.001); The level of CysC of them was higher than that of HC group (z=5.762, P<0.001), and was the similar with that of DC group (z=1.663, P=0.289). The partial correlation coefficient between NGAL and the occurrence of IS was the highest (rp=0.341, P<0.001) in IS patients with normal kidney function. However, the partial correlation coefficient between CysC and IS was the highest (rp=0.460) , P<0.001) in IS patients with chronic kidney disease (CKD). For patients with normal kidney function, only NGAL was a risk factor for IS [OR(95%CI)=6.54(3.75,11.41)], and had the certain predictive performance AUC=0.734(z=12.928, P<0.001). However, for CKD patients, CysC has better predictive performance for IS occurrence AUC=0.835 (z=11.343, P<0.001) and risk assessment ability [OR(95%CI)=5.97(2.45, 14.56)] than NGAL.Conclusion IS is related to kidney injury and neuroinflammation. NGAL and CysC are suitable for IS prediction in patients with normal kidney function and CKD, respectively. Researchers should pay attention to the changes of NGAL and CysC for the prevention and treatment of stroke in these two types of patients, respectively.

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“… 7 , 16 , 17 , 18 , 19 Patients with acute ischemic stroke with AKI were also shown to have high urine and plasma NGAL levels. 20 NGAL appears to be most sensitive and specific in homogeneous patient populations with temporally predictable forms of AKI. Published studies have also identified age as an effective modifier of NGAL’s performance as an AKI biomarker, with better predictive ability in children (overall AUC‐ROC, 0.93) than in adults (AUC‐ROC, 0.78).…”

Section: Discussionmentioning

confidence: 95%

Analysis of the diagnostic capabilities of urinary neutrophil gelatinase‐associated lipocalin and serum procalcitonin for acute kidney injury at the early stage of critical care intensive care unit admission

Imoto

Wakasaki

Izumida

et al. 2021

Clinical Laboratory Analysis

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Background Acute kidney injury (AKI) is a disease that negatively affects patient prognosis and requires early diagnosis and treatment. Biomarkers that predict AKI are needed for early diagnosis of this disease. Methods We compared the AKI group and the non‐AKI group in patients who were admitted to our critical care intensive care unit (ICU) and conducted a comparative study focusing on urinary neutrophil gelatinase‐associated lipocalin (U‐NGAL) and serum procalcitonin (PCT). Results Seventy‐one out of 106 ICU inpatients were diagnosed with AKI in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Among the patients who were diagnosed with AKI stages 1 to 3, 94.4% of all patients reached the maximum stage by day 5 after admission. Comparing the non‐AKI group and AKI stage 1 to 3 on days 1 to 3 after admission, U‐NGAL and PCT levels in the stage 3 group were significantly higher than those in the non‐AKI group. Additionally, in receiver operating characteristic curve (ROC) analysis on days 1–3 after admission, U‐NGAL and PCT levels can be used as biomarkers for the diagnosis of AKI, and in particular, AKI stage 3 can be predicted and diagnosed with high accuracy. U‐NGAL and PCT levels were also significantly higher in AKI due to sepsis and acute pancreatitis and due to sepsis, respectively. Conclusions Measuring U‐NGAL and PCT levels as biomarkers for AKI may further improve the accuracy of AKI diagnosis in critical care ICU.

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The clinical significance of neutrophil gelatinase‐associated lipocalin in ischemic stroke patients with acute kidney injury

Cited by 9 publications

References 28 publications

A novel risk model based on white blood cell-related biomarkers for acute kidney injury prediction in patients with ischemic stroke admitted to the intensive care unit

A novel risk model based on white blood cell-related biomarkers for acute kidney injury prediction in patients with ischemic stroke admitted to the intensive care unit

Differential Performance of Neutrophil Gelatinase-Associated Lipocalin and Cystatin C to Predict Ischemic Stroke

Analysis of the diagnostic capabilities of urinary neutrophil gelatinase‐associated lipocalin and serum procalcitonin for acute kidney injury at the early stage of critical care intensive care unit admission

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