Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of cardiac surgery associated acute kidney injury

Liebetrau, Christoph; Dörr, Oliver; Baumgarten, Heike; Gaede, Luise; Szardien, Sebastian; Blumenstein, Johannes; Rolf, Andreas; Möllmann, Helge; Hamm, Christian W.; Walther, Thomas; Nef, Holger; Weber, Michael A.

doi:10.3109/00365513.2013.787149

Cited by 40 publications

(30 citation statements)

References 26 publications

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“…Positive relationships with WBC count and resistin for both groups are in line with the view that serum NGAL could serve as an inflammatory marker in a range of clinical settings [45][46][47]. This lipocalin is expressed by neutrophils and various epithelial cells and has received attention as an acute kidney injury marker because of its early upregulation in the damaged tubular cells [7,48]. High expression of NGAL in atheromatous plaques and its role in inflammation might explain the previous finding that this biomarker could prove useful in discriminating between unstable and stable CAD patients [49,50].…”

Section: Discussionsupporting

confidence: 49%

Early Biomarkers of Renal Damage in Relation to Arterial Stiffness and Inflammation in Male Coronary Artery Disease Patients

Paapstel

Zilmer²,

Eha³

et al. 2016

Kidney Blood Press Res

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Background/Aims: Plasma neutrophil gelatinase-associated lipocalin (NGAL), urinary liver-type fatty acid-binding protein (L-FABP) and urinary kidney injury molecule-1 (KIM-1) have emerged as promising biomarkers for both acute and chronic kidney injury that also provide prognostic value for cardiovascular morbidity and mortality. Our aim was to evaluate their relationships with arterial stiffness and inflammation in coronary artery disease (CAD) patients and in clinically healthy controls. Methods: We studied 52 patients with CAD (age 63.2 ± 9.2 years) and 41 healthy controls (age 60.1 ± 7.2 years). Urinary L-FABP and KIM-1 as well as serum NGAL, adiponectin and resistin levels were measured using the enzyme-linked immunosorbent assay method. The technique of applanation tonometry was used for non-invasive pulse wave analysis and pulse wave velocity assessments. Results: Urinary L-FABP and KIM-1 were independent determinants of cf-PWV for the CAD patients (R²=0.584, P<0.001) but not for the controls. Adiponectin correlated with log-KIM-1 (r=0.31, P=0.028) only for the patients, while NGAL correlated with WBC count (rho=0.29, P=0.038; r=0.35, P=0.029) and resistin (rho=0.60, P<0.001; r=0.57, P<0.001) for both the CAD and control groups, respectively. Conclusion: Our findings suggest that urinary L-FABP and KIM-1 may be independently associated with aortic stiffness in individuals with CAD.

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Section: Discussionsupporting

confidence: 49%

Early Biomarkers of Renal Damage in Relation to Arterial Stiffness and Inflammation in Male Coronary Artery Disease Patients

Paapstel

Zilmer²,

Eha³

et al. 2016

Kidney Blood Press Res

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“…The most studied and promising for routine clinical use of these markers is NGAL. Some studies evaluated pre-operative and post-operative 19 biomarkers, while some others evaluated intraoperative 20 temporal relation and predictive ability of several AKI biomarkers. As described in detail in a recent review, 21 serum and urine NGAL have been shown in a number of studies as independent predictors of development of postoperative AKI in patients undergoing cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Serum uric acid may predict development of progressive acute kidney injury after open heart surgery

et al. 2014

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Objectives: Acute kidney injury (AKI) is a common complication of cardiac surgery developing in 25-35% cases. Recently, neutrophil gelatinase-associated lipocalin (NGAL) was shown to predict AKI development earlier than serum creatinine. Some studies demonstrated the predictive role of post-operative serum uric acid (SUA) as an early marker of AKI. We aimed to study the role of serum and urine NGAL as well as SUA to predict progression of AKI. Design and methods: This is a prospective observational study of patients undergoing cardiac surgery. Blood and urine samples for measurement of uric acid, serum and urine NGAL levels were collected prior to cardiac surgery (0 h), and in the time course at 2nd and 24th hours after surgery. Patients who developed AKI were divided into two subgroups as progressing and non-progressing AKI.Results: Sixty patients (42 males, 18 females) were included. After cardiac surgery, 40 patients developed AKI, 20 of whom non-progressing AKI, and 20 progressing AKI. All of the markers significantly increased in AKI patients. A receiver operator characteristics (ROC) curve analysis showed higher predictive ability of SUA for progressing AKI compared with serum and urine NGAL. When compared markers obtained at the second hour after surgery, UA had significantly large AUC than NGAL to predict AKI developed at 24 and 48 h, particularly in patients, who require renal replacement therapy (RRT). Conclusion: Uric acid seems to predict the progression of AKI and RRT requirement in patients underwent cardiac surgery better than NGAL.

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“…We could not find any study determined the independent predictors of urinary NGAL. Most of the studies addressed the value of UNGAL as a predictor of acute kidney injury [38]- [40]. We constructed a ROC curve to detect the cut off value of log UNGAL/Creatinine ratio to determine the normal value of log UNGAL/Creatinine ratio and it was found 1.035 Pg/ml with good AUC, sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

Urinary Neutrophil Gelatinase Associated Lipocalin as a Marker of Tubular Damage in Type 2 Diabetic Patients with and without Albuminuria

ALrefai¹,

Tayel²,

Ragheb³

et al. 2014

OJNeph

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Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of cardiac surgery associated acute kidney injury

Abstract: Urinary NGAL is a biomarker for very early risk stratification of AKI after cardiac surgery and may be useful as a basis for early interventional strategies to prevent CSA-AKI.

Cited by 40 publications

References 26 publications

Early Biomarkers of Renal Damage in Relation to Arterial Stiffness and Inflammation in Male Coronary Artery Disease Patients

Early Biomarkers of Renal Damage in Relation to Arterial Stiffness and Inflammation in Male Coronary Artery Disease Patients

Serum uric acid may predict development of progressive acute kidney injury after open heart surgery

Urinary Neutrophil Gelatinase Associated Lipocalin as a Marker of Tubular Damage in Type 2 Diabetic Patients with and without Albuminuria

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