Comment on “Urinary NGAL as a Diagnostic and Prognostic Marker for Acute Kidney Injury in Cirrhosis”

Weng, Fangbin

doi:10.14309/ctg.0000000000000382

Cited by 6 publications

(3 citation statements)

References 3 publications

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“…Relative variations in serum creatinine are used to categorise and characterise AKI in cirrhosis. A higher AKI stage, or a more serious damage, is linked to a higher 90-day death rate (4) . It is connected to a worse prognosis (5) .…”

Section: Introductionmentioning

confidence: 99%

Urinary Neutrophil Gelatinase Associated lipocalin (NGAL) as A Biomarker of Acute Kidney Injury in Patients with Liver Cirrhosis

2023

The Egyptian Journal of Hospital Medicine

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Background: The severity of acute kidney injury (AKI) syndrome varies. The blood urea nitrogen (BUN) and creatinine (Cr) retention, as well as a rapid drop in the glomerular filtration rate (GFR), are its defining features. The discovery of a superior gold standard to serum Cr concentration or urine output, as well as proof that a markerdirected therapy strategy may enhance clinical outcomes, would be significant step forward for AKI biomarker research. Objective: To determine if urine neutrophil gelatinase associated lipocalin (uNGAL) is a reliable indicator of AKI in patients with liver cirrhosis. Patients and methods: This study included 80 cirrhotic patients. Patients were allocated into two groups as follows: group I: 30 cirrhotic cases with normal kidney functions (without AKI) and group II: 50 cirrhotic cases with AKI who were divided into 3 subgroups according to type of AKI: group IIa included 20 cases with prerenal AKI, group IIb included 20 cases with hepatorenal syndrome (HRS-AKI) and group IIc included 10 cases with acute tubular necrosis (ATN). Results: In terms of uNGAL, there were statistically significant variations across the groups that were examined (P value <0.001) with mean uNGAL value is highest in group IIc (ATN) (259.80±44.364 ng/ml) followed by group IIb (HRS-AKI) (192.85±40.782 ng/ml) than group IIa (Pre-renal AKI) (61.00±8.706 ng/ml) and group I (29.00±5.420 ng/ml). uNGAL at a cut-off value ≥239 ng/ml could differentiate ATN from HRS with sensitivity of 80%, 90% specificity, 80% PPV, 90% NPV, with an area under curve (AUC) = 0.880, and P value of ˂ 0.001. uNGAL at cutoff value >190 ng/ml had 100% sensitivity, 88.24% specificity, 60% PPV, and 100% NPV for predicting inhospital mortality in cirrhotic patients with AKI (AUC = 0.96; P ˂ 0.001). Conclusion:To diagnose and differentiate between various causes of AKI in cases with liver cirrhosis, uNGAL may be employed as an accurate biomarker. Additionally, it has prognostic value in such patients.

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Section: Introductionmentioning

confidence: 99%

Urinary Neutrophil Gelatinase Associated lipocalin (NGAL) as A Biomarker of Acute Kidney Injury in Patients with Liver Cirrhosis

2023

The Egyptian Journal of Hospital Medicine

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“…The global incidence of meningitis is 20 cases per 100,000 people; that is, about 1.2 million; the incidence and etiology vary across geographic regions. Aseptic meningitis differs from bacterial meningitis if there is meningeal inflammation with no bacterial growth signs by CSF culture [4] .…”

Section: Introductionmentioning

confidence: 99%

Vitamin D-Binding Protein as a Diagnostic Biomarker for Acute Meningitis

2023

The Egyptian Journal of Hospital Medicine

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Background Meningitis is an acute inflammation of the pia, arachnoids, and the fluid in the subarachnoid space of the brain. Because there is no diagnostic biomarker, it is difficult to diagnose. Objective: The aim of the current study was to evaluate the validity of using cerebrospinal fluid (CSF) Vitamin-D Binding Protein (VDBP) as a new potential marker for diagnosing meningitis. Patients and methods: A cross-section study was conducted on 48 patients with manifestations suggesting an acute meningitis, 28 patients with an acute meningitis who were divided into bacterial group containing 10 patients and viral group containing 18 patients confirmed by laboratory investigations and 20 patients who were clinically suspected as an acute meningitis, but excluded by laboratory investigations, the study was conducted within the period from May 2022 to December 2022. CSF and blood samples were obtained in pairs. CSF and serum VDBP were measured in the 3 groups. CSF VDBP concentrations were compared versus serum VDBP concentrations according to disease (viral meningitis vs. bacterial meningitis vs non-meningitis). Receiver operating characteristic (ROC) analysis for diagnosing meningitis using CSF VDBP concentration was performed. Results: There was a statistical significant difference as regard the CSF VDBP (P<0.01) was found between viral, bacterial and control groups (2.49±.65, 2.43±.55 and 1.74±.25μg/mL, respectively). There was a statistical significant difference (P<0.05) in serum VDBP between the viral, bacterial and control groups (214. 5±36.5, 197.4±54.8 and 174.3±40.4 μg/mL, respectively). ROC curve analysis showed that the optimum cut-off level of CSF VDBP for diagnosing meningitis was 1.94 μg/mL with a sensitivity of 82.1% and specificity of 85%. AUC of CSF VDBP was 0.865 (95% CI: 0.761-0.969). Conclusion: The cerebrospinal fluid (CSF) Vitamin-D Binding Protein (VDBP) level demonstrated an excellent diagnostic performance. It could serve as a potential marker for diagnosing acute meningitis.

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“…We thank Dr. Weng for continuing the dialog on the use of neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis and prognosis of acute kidney injury (AKI) and cirrhosis (1). The primary aim of our prospective cohort study was to validate findings from 2 separate cohorts from European investigators around the use of urinary NGAL in AKI and decompensated cirrhosis.…”

mentioning

confidence: 99%