The Use of Plasma and Urine Neutrophil Gelatinase Associated Lipocalin (NGAL) and Cystatin C in Early Diagnosis of Septic Acute Kidney Injury in Critically Ill Patients

Aydoğdu, Müge; Gürsel, Gül; Sancak, Banu; Yeni, Serpil; Sarı, Gülçin; Tasyurek, S; Türk, Murat; Yüksel, Seher; Şeneş, Mehmet; Öziş, Türkan Nadir

doi:10.1155/2013/740351

Cited by 60 publications

(57 citation statements)

References 28 publications

(53 reference statements)

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“…We have demonstrated a strong correlation between markers of inflammatory status (WBC, CRP, PCT) and both sNGAL and uNGAL. The fact that the correlation between NGAL levels and CRP or PCT was stronger than with WBC values, indicates damage to endothelial cells other than of tubular origin 6,7,22,23,25 plays a greater role in the release of NGAL than the activation of neutrophils. It is well known that immunological response of immature newborns is weaker and neutrophil activation limited.…”

Section: Discussionmentioning

confidence: 98%

“…[16][17][18][19][20][21] A new potential biomarker postulated as a more sensitive parameter of AKI is NGAL. 22 The introduction of this parameter into routine diagnostic workup requires establishing the reference values and knowledge of methodological limitations. Our study gives rise to the need of determining normal ranges of age and BW, especially of uNGAL.…”

Section: Discussionmentioning

confidence: 99%

“…Similar results were previously obtained in term newborns by us 24 and other researchers. 22,23,25 In our project, sNGAL and uNGAL values were checked as a surrogate, hence possibly more sensitive parameter of kidney injury. To make the study group more homogenous in respect to the stage of maturity, we distinguished two subgroups based on GA.…”

Section: Discussionmentioning

confidence: 99%

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Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns

et al. 2015

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Background: Neutrophil gelatinase-associated lipocalin (NGAL) is postulated to be a highly sensitive and specific marker of acute kidney injury (AKI). The aim of this study was to assess the factors affecting serum and urine total NGAL in preterm newborns, limiting the role of this new potential marker of AKI. Methods: Serum and urinary total NGAL concentrations were determined in 57 preterm infants admitted to the Neonatal Intensive Care Unit in the following points of time: first week of life, between 8 and 14 days of life, and after the fourth week of life. Patients' clinical conditions were evaluated based on NTISS (Neonatal Therapeutic Intervention Scoring System). Two gestational age subgroups were distinguished: 29 and 30 to 35 weeks of gestation. We sought correlation between total NGAL values and gestational age, birth weight, Apgar score and severity of clinical condition, with particular interest in inflammatory status. Results: Serum and urinary total NGAL concentration correlated with inflammatory markers, such as CRP and procalcitonin, as well as with NTISS values. Birth weight and gestational age influence urinary NGAL (uNGAL) values in the first two weeks of life. In AKI (N ¼ 8) patients uNGAL values were significantly higher than in non-AKI newborns. Conclusions: We conclude that inflammatory status and prematurity limits the specificity of total NGAL measurement as a marker of AKI.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns

et al. 2015

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“…Kadar NGAL urin pada 2 jam menjalani CPB hampir secara sempurna memprediksi pasien yang akan berkembang menjadi CGA. 7 Penelitian lain pada 103 orang dewasa yang menjalani cardiopulmonary bypass (CPB), ternyata CGA berkembang 31% pada mereka yang kadar KIM-1 urinnya meningkat sekitar 40% setelah 2 jam operasi dan 100% pada waktu jam ke-24. 8 Dengan demikian, KIM-1 merupakan kandidat yang menjanjikan untuk dimasukkan dalam penanda biologis CGA urin.…”

Section: Pendahuluanunclassified

Sensitivitas dan Spesifisitas Cystatin C dan Kreatinin Serum dalam Mendiagnosis Cedera Ginjal Akut pada Pasien Sepsis yang Dirawat di Ruang Rawat Intensif RSUP H. Adam Malik Medan

Arifin¹,

Kurniawan²

2016

jap

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AbstrakKreatinin serum memiliki banyak keterbatasan dalam mendiagnosis cedera ginjal akut (CGA) terutama dalam ruang lingkup unit perawatan intensif sehingga kurang sensitif untuk menggambarkan tingkat disfungsi ginjal pada pasien sakit kritis. Dari sekian banyak penanda biologis baru yang tersedia, terdapat 4 penanda biologis yang saat ini secara luas digunakan para klinisi di seluruh dunia untuk mendeteksi CGA, antara lain neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, KIM-1, dan interleukin-18. Tujuan penelitian ini adalah mengetahui sensitivitas dan spesifisitas cystatin C dan kreatinin serum dalam mendiagnosis cedera ginjal akut pada pasien sepsis yang dirawat di ruang rawat intensif. Jenis penelitian ini adalah uji diagnostik dengan jumlah sampel 24 pasien dan dikerjakan di ruang rawat intensif Rumah Sakit H. Adam Malik (RSHAM) periode Februari-Maret 2014. Populasi dalam penelitian ini adalah semua pasien dewasa dengan sepsis, sepsis berat, dan syok sepsis di ruang rawat intensif. Uji statistik dilakukan dengan metode receiving operator characteristics (ROC) melalui perangkat lunak SPSS 17. Hasil penelitian ini menunjukkan bahwa cystatin C serum lebih superior dibanding dengan kreatinin serum dalam mendeteksi CGA pada pasien sepsis di ruang rawat intensif. Cystatin C memiliki sensitivitas, nilai prediksi positif, nilai prediksi negatif, dan area under curve-receiving operator characteristics (AUC-ROC) yang lebih tinggi dibanding dengan kreatinin serum. Namun, dari nilai spesifisitas dijumpai nilai yang sama pada kedua penanda biologis. Simpulan, cystatin C dapat dijadikan penanda biologis alternatif untuk deteksi CGA pada pasien sepsis di RRI (Ruang Rawat Intensif) dengan nilai diagnostik yang lebih baik.Kata kunci: Cedera ginjal akut, cystatin C serum, kreatinin serum Sensitivity and Specificity of Serum Cystatin C and Creatinine for Diagnosing Acute Kidney Injury in Sepsis Patients Treated in Intensive Care Unit at H. Adam Malik Hospital Medan AbstractSerum creatinine has many limitations when being used to diagnose acute kidney injury (AKI), especially in the scope of intensive care unit due to its low sensitivity to depict the kidney dysfunctional level of criticallyill patients. Out of numerous new available biological markers, four biological markers are widely used all over the world to detect AKI, e.g. neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, KIM-1, and interleukin-18. The purpose of this study was to determine the sensitivity and specificity of serum cystatin C and creatinine in establishing the diagnosis of acute kidney injury in sepsis patients treated in intensive care room. This study was a diagnostic test to 24 patients and conducted in intensive care room of H. Adam Malik Hospital during the period of February-March 2014. Population in this study is all adult patients with sepsis, severe sepsis, and septic shock in the intensive care room. A statistical test was conducted using receiving operator characteristics (ROC) method using SPSS 17 software. The r...

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“…uNGAL was also measured in one study of sepsis in which 63 (42%) patients out of 151 patients had increased uNGAL. 23 Haase-Fielitz et al 24 studied adult cardiac surgery patients and they reported that predictive value of plasma NGAL increases with increasing grade of AKI.…”

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confidence: 99%

Diagnostic accuracy of urinary neutrophil gelatinase-associated lipocalin in patients with septic acute kidney injury

Patel¹,

Sachan²,

Shyam

et al. 2016

IJNRD

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Background: Sepsis is the most common cause of acute kidney injury (AKI). Very few studies have investigated the predictive properties of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a marker of AKI in septic patients. The aim of this study is to examine uNGAL in septic patients with and without AKI and to evaluate its predictive value. Methods: We prospectively studied 155 patients with sepsis over a period of 1 year. Urine was analyzed for neutrophil gelatinase-associated lipocalin at 12, 24, and 48 hours after admission. Patients with <24-hour stay and those with chronic kidney disease were excluded. AKI was classified according to the Acute Kidney Injury Network guidelines. Results: The differences in mean change of uNGAL at 12, 24, and 48 hours were 80.00±7.00 ng/mL and 128.13±22.46 ng/mL, respectively in septic AKI, and 02.07±0.80 ng/mL and 26.13±15.12 ng/mL, respectively in septic non-AKI. At baseline or 12 hours, the cutoff value of 34.32 ng/mL had a sensitivity and specificity of 86.36 and 80.60, respectively and an area under curve of 0.81 (95% CI: 0.73-0.89) for predicting AKI. At the cutoff value 199.99 ng/mL sensitivity and specificity of 90.0 and 64.66, respectively and an area under curve of 0.82 (95% CI, 0.75-0.88) for predicting AKI. Conclusion:The baseline or 12-hour uNGAL is highly sensitive but a less specific predictor of AKI in septic patients.

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The Use of Plasma and Urine Neutrophil Gelatinase Associated Lipocalin (NGAL) and Cystatin C in Early Diagnosis of Septic Acute Kidney Injury in Critically Ill Patients

Cited by 60 publications

References 28 publications

Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns

Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns

Sensitivitas dan Spesifisitas Cystatin C dan Kreatinin Serum dalam Mendiagnosis Cedera Ginjal Akut pada Pasien Sepsis yang Dirawat di Ruang Rawat Intensif RSUP H. Adam Malik Medan

Diagnostic accuracy of urinary neutrophil gelatinase-associated lipocalin in patients with septic acute kidney injury

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