Urinary neutrophil gelatinase-associated lipocalin may aid prediction of renal decline in patients with non-proteinuric Stages 3 and 4 chronic kidney disease (CKD)

Abstract

The utilization of uNCR in addition to conventional established cardiovascular and renal risk factors may improve the prediction of disease progression in elderly Caucasian pre-dialysis CKD patients with low-grade proteinuria.

Independent associations of urine neutrophil gelatinase–associated lipocalin and serum uric acid with interstitial fibrosis and tubular atrophy in primary glomerulonephritis

“…Correlations of urine NGAL and GFR have been observed in previous studies in CKD. 5,20,21 A trend for inverse correlation of NGAL with GFR was also observed in our study, but this did not reach statistical significance. Lower numbers of patients with advanced disease and higher mean GFR could account for the differences in the relationship between NGAL with GFR in our study compared to others.…”

“…18 More recently, urine NGAL has been shown to be elevated in patients with chronic tubulointerstitial disease, 9,19 and urine NGAL may be predictive of long-term decline in renal function in patients with CKD. 5,20,21 Limited data are available for proteinuric GN. Ding et al found increases in urinary, but not serum, NGAL in patients with advanced IgA nephropathy levels consistent with local renal generation as the major source of urinary NGAL.…”

“…Currently, there are no universally accepted biomarkers to predict tubulointerstitial lesions, 2 but both neutrophil gelatinase-associated lipocalin (NGAL) and serum uric acid (UA) have shown promise as predictors of progression in patients with chronic kidney diseases (CKD) without kidney biopsies, in separate studies. 5,6 NGAL is a protein originally purified from human neutrophils and subsequently shown to be highly expressed in renal tubules upon injury. 7 Currently, there are considerable data supporting NGAL as a biomarker to detect acute kidney injury (AKI).…”

Urine Injury Biomarkers and Risk of Adverse Outcomes in Recipients of Prevalent Kidney Transplants: The Folic Acid for Vascular Outcome Reduction in Transplantation Trial

“…6,[37][38][39][40][41][42][43][44] Similar to our findings, among patients with native CKD, elevated urine NGAL has been shown to be significantly associated with progression of CKD or incident ESRD. 3,45,46 Some studies 39 but not all 6 have also noted associations of higher urine NGAL with incident CKD. For example, among high-risk American Indians with type 2 diabetes, elevations in urine NGAL were significantly associated with risk of ESRD.…”

Urinary Biomarkers and Risk of ESRD in the Atherosclerosis Risk in Communities Study

“…Several urinary markers of tubular injury associated with AKI may also have clinical utility as markers of chronic kidney damage and are under investigation as markers of CKD and CKD progression (5)(6)(7)(8). As part of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) CKD Biomarkers Consortium, we sought to determine whether levels of urinary biomarkers liver fatty acid binding protein (L-FABP), kidney injury molecule 1 (KIM-1), N-acetyl-b-D-glucosaminidase (NAG), and neutrophil gelatinase-associated lipocalin (NGAL) are associated with incident ESRD in a nested case-control study of adults from the Atherosclerosis Risk in Communities (ARIC) Study.…”