Association of plasma neutrophil gelatinase-associated lipocalin (NGAL) with sepsis and acute kidney dysfunction

Mårtensson, Johan; Bell, Max; Xu, Shaoyuan; Bottai, Matteo; Ravn, Bo; Venge, Per; Martling, Claes‐Roland

doi:10.3109/1354750x.2013.787460

Cited by 49 publications

(38 citation statements)

References 36 publications

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“…The fact that NGAL levels are correlated with CPB time and that homodimeric NGAL is the predominant form in these patients' urine [53] suggests that the neutrophils, rather than the kidney tubular cells, are the main source. Similar conclusions can be drawn from general ICU populations where sepsis is associated with elevated plasma NGAL independent of degree of renal impairment [37,54]. …”

Section: Ngal In Acute Kidney Injurysupporting

confidence: 56%

The Rise and Fall of NGAL in Acute Kidney Injury

Mårtensson

Bellomo²

2014

Blood Purif

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207

136

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For many years, neutrophil gelatinase-associated lipocalin (NGAL) has been considered the most promising biomarker of acute kidney injury (AKI). Commercial assays and point-of-care instruments, now available in many hospitals, allow rapid NGAL measurements intended to guide the clinician in the management of patients with or at risk of AKI. However, these assays likely measure a mixture of different NGAL forms originating from different tissues. Systemic inflammation, commonly seen in critically ill patients, and several comorbidities contribute to the release of NGAL from haematopoietic and non-haematopoietic cells. The unpredictable release and complex nature of the molecule and the inability to specifically measure NGAL released by tubular cells have hampered its use a specific marker of AKI in heterogeneous critically ill populations. In this review, we describe the nature and cellular sources of NGAL, its biological role and diagnostic ability in AKI and the increasing concerns surrounding its diagnostic and clinical value.

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Section: Ngal In Acute Kidney Injurysupporting

confidence: 56%

The Rise and Fall of NGAL in Acute Kidney Injury

Mårtensson

Bellomo²

2014

Blood Purif

Self Cite

207

136

View full text Add to dashboard Cite

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“…Another issue is that NGAL production is increased by complex inflammatory responses and organ damage that occurs in sepsis (14,28,29). Although the high levels of sNGAL could be a result of its production from neutrophils and other injured organs in sepsis, sNGAL levels were not different between the BiNx/BUO alone and BiNx/BUO with CLP groups (Fig.…”

Section: Discussionmentioning

confidence: 75%

Serum Neutrophil Gelatinase Associated Lipocalin (NGAL) Outperforms Serum Creatinine in Detecting Sepsis-Induced Acute Kidney Injury, Experiments on Bilateral Nephrectomy and Bilateral Ureter Obstruction Mouse Models

Leelahavanichkul

Somparn

Issara-Amphorn

et al. 2016

Shock

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Serum neutrophil gelatinase associated lipocalin (sNGAL), a promising acute kidney injury (AKI) biomarker produced by renal and non-renal tissues, might be affected by sepsis. We evaluated sNGAL in zero glomerular filtration rate models [bilateral ureter obstruction (BUO) and bilateral nephrectomy (BiNx)] with subsequent cecal ligation and puncture (CLP)-induced sepsis in 6 to 8-week-old ICR mice. We found that sNGAL increased earlier than serum creatinine (Scr) in BiNx/BUO with and without CLP. The earliest time-point of increased sNGAL in BiNx+CLP was 1 h after surgery. Scr, but not sNGAL, was lower at 18 h after BiNx/BUO+CLP compared with BiNx/BUO alone. Compared with BUO, BiNx had higher, and equal sNGAL at 1 to 18 h and 36 h, respectively. Additionally, similar NGAL expression in internal organs (heart, lung, liver, and spleen) and survival rates indicated the comparable severity of BiNx and BUO. Serum interleukin (IL)-6 was increased and correlated with sNGAL in BiNx/BUO with and without sepsis. In summary, we demonstrated: sNGAL is an early AKI biomarker, which is not affected by sepsis; sNGAL is mainly produced by extrarenal sources as demonstrated by the comparable sNGAL in BiNx and BUO; the saturation of renal NGAL re-absorption in BUO is demonstrated by lower sNGAL in BUO at 1 to 18 h, but not at 36 h when compared with BiNx; and a correlation of sNGAL and IL-6 implied sNGAL is a good sepsis prognostic biomarker. Therefore, sNGAL is a more beneficial sepsis-AKI biomarker than Scr.

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“…Martensson et al (25) found that elevated plasma NGAL, procalcitonin, and CRP are associated with sepsis independent of the level of kidney function and that NGAL outperforms procalcitonin and CRP as a marker to distinguish bacterial infection from noninfective causes of systemic inflammatory response syndrome by analysis of more than 1,300 plasma samples. In our study, the relationship between increased NGAL and AKI is evident in which high NGAL is strongly associated with increased creatinine, reduced eGFR, and more frequent hypoperfusion and thus likely AKI.…”

Section: Discussionmentioning

confidence: 98%

Increased Neutrophil Gelatinase–Associated Lipocalin is Associated with Mortality and Multiple Organ Dysfunction Syndrome in Severe Sepsis and Septic Shock

Wang

Chen

Zhang

et al. 2015

Shock

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Association of plasma neutrophil gelatinase-associated lipocalin (NGAL) with sepsis and acute kidney dysfunction

Abstract: Plasma NGAL can help clinicians to identify bacterial infections in critically ill patients.

Cited by 49 publications

References 36 publications

The Rise and Fall of NGAL in Acute Kidney Injury

The Rise and Fall of NGAL in Acute Kidney Injury

Serum Neutrophil Gelatinase Associated Lipocalin (NGAL) Outperforms Serum Creatinine in Detecting Sepsis-Induced Acute Kidney Injury, Experiments on Bilateral Nephrectomy and Bilateral Ureter Obstruction Mouse Models

Increased Neutrophil Gelatinase–Associated Lipocalin is Associated with Mortality and Multiple Organ Dysfunction Syndrome in Severe Sepsis and Septic Shock

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