Neutrophil gelatinase-associated lipocalin (NGAL) predicts the occurrence of malaria-induced acute kidney injury

Abstract

BackgroundAcute kidney injury (AKI) is a frequently encountered complication of imported Plasmodium falciparum infection. Markers of structural kidney damage have been found to detect AKI earlier than serum creatinine-based prediction models but have not yet been evaluated in imported malaria. This pilot study aims to explore the predictive performance of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) for AKI in travellers with imported P. falciparum infection.MethodsThirty-nine patients with imported falciparum malaria from the Rotterdam Malaria Cohort with available serum and urine samples at presentation were included. Ten of these patients met the criteria for severe malaria. The predictive performance of NGAL and KIM-1 as markers for AKI was compared with that of serum creatinine.ResultsSix of the 39 patients (15 %) developed AKI. Serum and urine NGAL and urine KIM-1 were all found to have large areas under the receiver operating characteristics curves (AUROC) for predicting AKI. Urine NGAL was found to have an excellent performance with positive predictive value (PPV) of 1.00 (95 % CI 0.54–1.00), a negative predictive value (NPV) of 1.00 (95 % CI 0.89–1.00) and an AUROC of 1.00 (95 % CI 1.00–1.00).ConclusionA good diagnostic performance of NGAL and KIM-1 for AKI was found. Particularly, urine NGAL was found to have an excellent predictive performance. Larger studies are needed to demonstrate whether these biomarkers are superior to serum creatinine as predictors for AKI in P. falciparum malaria.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1516-y) contains supplementary material, which is available to authorized users.

Retracted: Early Detection of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection With Doppler Renal Resistive Index

“…Patients in this study were younger (50 ± 11 years) than the patients in the previous report (77 or 87 years) . Using 0.71 as the cutoff value for predicting AKI is close to several other studies, such as septic shock, hip fracture, and major orthopedic surgery . Other researchers have reported the optimal cutoff as being 0.73 for RRI to predict persistent AKI …”

“…Moreover, AKI may be present in person with normal urine output . New biomarkers for earlier detection of AKI with more sensitivity was urgently needed in the postoperative management of AKI parents . Renal resistive index (RRI) was an early predictor of AKI and has been studied in several clinical situations .…”

“…11 New biomarkers for earlier detection of AKI with more sensitivity was urgently needed in the postoperative management of AKI parents. [12][13][14] Renal resistive index (RRI) was an early predictor of AKI and has been studied in several clinical situations. [15][16][17] Doppler renal resistive index (DRRI) has already been used for assessing instant renal perfusion, which correlates with sCr and urine output.…”

Kidney involvement in malaria: an update

“…AKI is a known complication of malaria and can occur in around 40% of patients with severe disease by P. falciparum in endemic regions, contributing to high mortality rate, around 75% of cases 12 , 17 , 18 . P. falciparum causes the most severe form of malaria and is responsible for most cases of AKI 16 .…”

“…A recent study has found evidence that 31% of patients with malaria-associated AKI had normal levels of creatinine at presentation, illustrating the importance of new AKI biomarkers. NGAL seems to be a good biomarker for malaria-associated AKI and has already been investigated in different types of kidney injury 18 .…”