2009
DOI: 10.1053/j.ajkd.2009.07.020
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Accuracy of Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Diagnosis and Prognosis in Acute Kidney Injury: A Systematic Review and Meta-analysis

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Cited by 1,146 publications
(961 citation statements)
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“…Consequently, research in the last decade has focussed on the discovery and validation of more specific and sensitive markers of tubular damage/functional impairment. The most advanced biomarkers promise to identify patients at risk of AKI, diagnose AKI earlier than conventional tests and prognosticate risk of progression, including need for (RRT) renal replacement therapy [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The hope is that, with such an approach and more timely and relevant interventions, the outcome of patients with AKI can be improved.…”
mentioning
confidence: 99%
“…Consequently, research in the last decade has focussed on the discovery and validation of more specific and sensitive markers of tubular damage/functional impairment. The most advanced biomarkers promise to identify patients at risk of AKI, diagnose AKI earlier than conventional tests and prognosticate risk of progression, including need for (RRT) renal replacement therapy [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The hope is that, with such an approach and more timely and relevant interventions, the outcome of patients with AKI can be improved.…”
mentioning
confidence: 99%
“…One such marker is neutrophil gelatinase-associated lipocalin (NGAL), which is a 25-kDa gelatinase-bound protein that was originally characterized in neutrophils. In recent years, NGAL has been shown to be produced in the kidney following ischemic or nephrotoxic injury in both animals and humans, and has clinical utility for the early or differential diagnosis and prognostic evaluation of AKI [3-6]. …”
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confidence: 99%
“…Furthermore, their findings augment the growing evidence-base suggesting the utility of biomarkers of kidney damage to provide additional diagnostic and prognostic information regarding the presence, severity, and likely course of AKI in high-risk settings, beyond what can be discerned by the use of markers of renal function (GFR and urine output) alone. Such diagnostic and prognostic accuracy has the potential to significantly improve the clinical evaluation and management of AKI, including aggressive resuscitation of patients with AKI but no evidence of kidney damage ('prerenal', reversible renal hypoperfusion resulting in decreased GFR) [4,6], and early initiation of dialysis in patients with evolving AKI caused by severe ATN (based upon biomarker evidence of severe renal tubular damage) [3,4,14]. Thus, the emerging use of novel AKI biomarkers of renal dysfunction and damage can offer the prospect of appropriate, early, goal-directed therapy of AKI in high risk patients, including prompt reversal where possible [6], and aggressive renal support where necessary [3,4,14].…”
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confidence: 99%
“…Although NGAL estimations may predict AKI occurring within 24 h (and maybe even within 48 h), they are not truly specific in that the other multiple problems and comorbidities our critically ill patients have can also elevate NGAL. This may also explain the fact that predictive ability of NGAL for AKI was found to be far better in children (AuROC 0.930; 95% CI 0.883-0.968) than in adults (AuROC 0.782; 95% CI, 0.689-0.872) in a recent meta-analysis [10].…”
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confidence: 99%
“…NGAL expression increases greatly in the presence of inflammation and injured epithelia, and this includes renal damage after ischemia reperfusion injury and nephrotoxicity [9]. In a recent systematic review and meta-analysis, the NGAL meta-analysis investigator group concluded that NGAL appears to be of diagnostic and prognostic value for AKI in critically ill patients [10]. However, the role of NGAL in critically ill patients was principally studied in highly selected populations, including children and adults following cardiac surgery or contrast-induced nephropathy.…”
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confidence: 99%