Neutrophil gelatinase-associated lipocalin (NGAL) in kidney injury – A systematic review

Marakala, Vijaya

doi:10.1016/j.cca.2022.08.029

Cited by 63 publications

(27 citation statements)

References 55 publications

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“…Hence, these adipokines may emerge as biomarkers for the diagnosis and prognosis of kidney diseases. It is important to note that bacterial infections may affect the urinary levels of adipokines [ 88 , 104 , 207 ], and this may limit the immediate clinical value of these biomarkers. The upregulation of adipokine synthesis in injured kidney cells or higher adipokine production in leukocytes and/or elevated circulating adipokine levels together with increased renal excretion rates seem to contribute to their urinary levels, and evaluation of the pathways mediating elevated urinary concentrations of these adipokines are of pathophysiological relevance.…”

Section: Discussionmentioning

confidence: 99%

“…Monomeric lipocalin-2 was released by human kidney 2 (HK-2) cells, which mimic proximal tubular kidney cells, while the dimer was secreted by neutrophils. Accordingly, in urine, the dimer was the predominant form in patients with urinary tract infections, but higher monomer concentrations were found in patients with acute kidney injury [ 88 , 104 ]. Serum lipocalin-2, but not urinary lipocalin-2, correlated with BMI, blood pressure, heart rate, triglycerides and high-sensitivity C-reactive protein.…”

Section: Adipokines In Urine and Fecesmentioning

confidence: 99%

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Fecal and Urinary Adipokines as Disease Biomarkers

et al. 2023

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The use of biomarkers is of great clinical value for the diagnosis and prognosis of disease and the assessment of treatment efficacy. In this context, adipokines secreted from adipose tissue are of interest, as their elevated circulating levels are associated with a range of metabolic dysfunctions, inflammation, renal and hepatic diseases and cancers. In addition to serum, adipokines can also be detected in the urine and feces, and current experimental evidence on the analysis of fecal and urinary adipokine levels points to their potential as disease biomarkers. This includes increased urinary adiponectin, lipocalin-2, leptin and interleukin-6 (IL-6) levels in renal diseases and an association of elevated urinary chemerin as well as urinary and fecal lipocalin-2 levels with active inflammatory bowel diseases. Urinary IL-6 levels are also upregulated in rheumatoid arthritis and may become an early marker for kidney transplant rejection, while fecal IL-6 levels are increased in decompensated liver cirrhosis and acute gastroenteritis. In addition, galectin-3 levels in urine and stool may emerge as a biomarker for several cancers. With the analysis of urine and feces from patients being cost-efficient and non-invasive, the identification and utilization of adipokine levels as urinary and fecal biomarkers could become a great advantage for disease diagnosis and predicting treatment outcomes. This review article highlights data on the abundance of selected adipokines in urine and feces, underscoring their potential to serve as diagnostic and prognostic biomarkers.

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Section: Discussionmentioning

confidence: 99%

Section: Adipokines In Urine and Fecesmentioning

confidence: 99%

Fecal and Urinary Adipokines as Disease Biomarkers

et al. 2023

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“…A recent systematic review has shown that NGAL appeared to have a predictive value irrespective of age, from newborn to 78 years. NGAL levels can accurately predict the outcome and severity of AKI occurring in several disease processes, including contrast-induced AKI during cardiac surgery, kidney-transplant rejection, chronic heart failure, and systemic inflammation in critically ill patients, even though the significance of NGAL is highly variable across studies [ 34 ]. In the setting of COVID-19 patients, a prospective cohort observational study consisting of 444 consecutive patients evaluated uNGA at hospital admission.…”

Section: Discussionmentioning

confidence: 99%

Serum and Urinary Biomarkers in COVID-19 Patients with or without Baseline Chronic Kidney Disease

Filev

Lyubomirova

Hristova

et al. 2023

JPM

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In a prospective, observational, non-interventional, single-center study, we assessed various plasma and urinary biomarkers of kidney injury (neutrophil gelatinase-associated Lipocain [NGAL], kidney-injury molecule-1 [KIM-1], and interleukin-18 [IL-18]); inflammation (IL-6, C-reactive protein [CRP]); plus angiotensin converting enzyme 2 (ACE2) in 120 COVID-19 patients (of whom 70 had chronic kidney disease (CKD) at emergency-department (ED) admission). Our aim was to correlate the biomarkers with the outcomes (death, acute kidney injury [AKI]). All patients had received a chest-CT scan at admission to calculate the severity score (0–5). Biomarkers were also assessed in healthy volunteers and non-COVID-19-CKD patients. These biomarkers statistically differed across subgroups, i.e., they were significantly increased in COVID-19 patients, except for urinary (u)KIM1 and uIL-18. Amongst the biomarkers, only IL-6 was independently associated with mortality, along with AKI and not using remdesivir. Regarding the prediction of AKI, only IL-6 and uKIM1 were significantly elevated in patients presenting with AKI. However, AKI could not be predicted. Having high baseline IL-6 levels was associated with subsequent ventilation requirement and death. The mortality rate was almost 90% when the chest CT-scan severity score was 3 or 4 vs. 6.8% when the severity score was 0–2 (p < 0.0001).

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“…By identifying potential AKI progression, we can initiate early intervention before life-threatening complications occur. Furthermore, several emerging AKI biomarkers, including tissue inhibitor of metalloproteinases-2 and insulin-like growth factor binding protein-7 (TIMP-2 × IGFBP-7), interleukin-18 (IL-18), and plasma NGAL, have been shown to predict the progression of AKI [ 19 – 21 ]. In particular, TIMP-2 × IGFBP-7 was confirmed for early AKI risk stratification in critically ill patients in multicenter studies and have been approved by the US FDA for clinical use [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

The furosemide stress test predicts the timing of continuous renal replacement therapy initiation in critically ill patients with acute kidney injury: a double-blind prospective intervention cohort study

Zhang

Zhang²,

Zhao

et al. 2023

Eur J Med Res

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Background Continuous renal replacement therapy (CRRT) remains a crucial treatment for critically ill patients with acute kidney injury (AKI), although the timing of its initiation is still a matter of contention. Furosemide stress testing (FST) may be a practical and beneficial prediction instrument. This research was meant to examine if FST can be used to identify high-risk patients for CRRT. Methods This study is a double-blind, prospective interventional cohort study. For patients with AKI receiving intensive care unit (ICU) income, FST was selected with furosemide 1 mg/kg intravenous (1.5 mg/kg intravenous if a loop diuretic was received within 7 days). Urinary volume more than 200 ml at 2 h after FST was FST-responsive, less than 200 ml was FST-nonresponsive. The FST results are kept strictly confidential from the clinician, who decides whether to initiate CRRT based on laboratory testing and clinical symptoms other than the FST data. The FST data are concealed from both the patients and the clinician. Results FST was delivered to 187 of 241 patients who satisfied the inclusion and exclusion criteria, with 48 patients responding to the test and 139 patients not responding. 18/48 (37.5%) of the FST-responsive patients received CRRT, while 124/139 (89.2%) of the FST-nonresponsive patients received CRRT. There was no significant difference between the CRRT and non-CRRT groups in terms of general health and medical history (P > 0.05). Urine volume after 2 h of FST was considerably lower in the CRRT group than in the non-CRRT group (35 ml, IQR5-143.75 versus 400 ml, IQR210-890; P = 0.000). FST non-responders were 2.379 times more likely to initiate CRRT than FST responders (95% CI 1.644–3.443, P = 0.000). The area under the curve (AUC) for initiating CRRT was 0.966 (cutoff of 156 ml, sensitivity of 94.85%, specificity of 98.04%, P < 0.001). Conclusion This study demonstrated that FST is a safe and practical approach for predicting the initiation of CRRT in critically ill AKI patients. Trial registrationwww.chictr.org.cn, ChiCTR1800015734, Registered 17 April 2018.

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Neutrophil gelatinase-associated lipocalin (NGAL) in kidney injury – A systematic review

Cited by 63 publications

References 55 publications

Fecal and Urinary Adipokines as Disease Biomarkers

Fecal and Urinary Adipokines as Disease Biomarkers

Serum and Urinary Biomarkers in COVID-19 Patients with or without Baseline Chronic Kidney Disease

The furosemide stress test predicts the timing of continuous renal replacement therapy initiation in critically ill patients with acute kidney injury: a double-blind prospective intervention cohort study

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