Predictive value of plasma neutrophil gelatinase‐associated lipocalin for acute kidney injury in intensive care unit patients after major non‐cardiac surgery

Shum, Hoi‐Ping; Leung, Natalie; Chang, Lili; Tam, Oi-Yan; Kwan, Arthur Ming-Chit; Chan, King‐Chung; Yan, Wei; Chan, Tak Mao

doi:10.1111/nep.12400

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…2). While sample collection and biomarker analysis were quite similar throughout all studies, only 15 studies [ 18 , 27 , 32 , 37 , 41 , 50 , 52 , 56 , 57 , 61 , 64 , 68 , 71 , 75 , 76 ] specified the clinical indications for initiation of RRT. Of these studies, seven [ 19 , 27 , 50 , 56 , 61 , 64 , 76 ] were rated as having set predefined criteria for RRT initiation.…”

Section: Resultsmentioning

confidence: 99%

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Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis

et al. 2018

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PurposeAcute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed evidence synthesis of the available literature to evaluate the value of biomarkers to predict receipt of RRT for AKI.MethodsWe conducted a PRISMA-guided systematic review and meta-analysis including all trials evaluating biomarker performance for prediction of RRT in AKI. A systematic search was applied in MEDLINE, Embase, and CENTRAL databases from inception to September 2017. All studies reporting an area under the curve (AUC) for a biomarker to predict initiation of RRT were included.ResultsSixty-three studies comprising 15,928 critically ill patients (median per study 122.5 [31–1439]) met eligibility. Forty-one studies evaluating 13 different biomarkers were included. Of these biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) had the largest body of evidence. The pooled AUCs for urine and blood NGAL were 0.720 (95% CI 0.638–0.803) and 0.755 (0.706–0.803), respectively. Blood creatinine and cystatin C had pooled AUCs of 0.764 (0.732–0.796) and 0.768 (0.729–0.807), respectively. For urine biomarkers, interleukin-18, cystatin C, and the product of tissue inhibitor of metalloproteinase-2 and insulin growth factor binding protein-7 showed pooled AUCs of 0.668 (0.606–0.729), 0.722 (0.575–0.868), and 0.857 (0.789–0.925), respectively.ConclusionThough several biomarkers showed promise and reasonable prediction of RRT use for critically ill patients with AKI, the strength of evidence currently precludes their routine use to guide decision-making on when to initiate RRT.Electronic supplementary materialThe online version of this article (10.1007/s00134-018-5126-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…Plasma, serum, and/or whole blood NGAL, analyzed in 22 studies [ 18 , 21 , 24 , 28 – 31 , 35 , 40 , 42 , 48 , 52 , 56 , 62 , 64 , 66 , 68 , 71 , 72 , 77 – 79 ] and 4391 patients, had a pooled AUC of 0.755 (0.706–0.803) (Fig. 4 ).…”

Section: Resultsmentioning

confidence: 99%

Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis

et al. 2018

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“…Nevertheless, the use of NGAL levels to predict AKI has been inadequately explored in Asian populations. Most available studies were limited by small sample sizes ( n = 76–151)[ 36 37 38 39 ] or focused on patients with sepsis[ 40 ] or acute decompensated heart failure alone. [ 41 ] However, the limited studies[ 35 40 ] on the long-term prognostic value of NGAL in patients in the ED can be further supplemented.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil gelatinase-associated lipocalin: a biochemical marker for acute kidney injury and long-term outcomes in patients presenting to the emergency department

Teo

Lim

Ying

et al. 2022

Singapore Medical Journal

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Introduction: Creatinine has limitations in identifying and predicting acute kidney injury (AKI). Our study examined the utility of neutrophil gelatinase-associated lipocalin (NGAL) in predicting AKI in patients presenting to the emergency department (ED), and in predicting the need for renal replacement therapy (RRT), occurrence of major adverse cardiac events (MACE) and all-cause mortality at three months post visit. Methods: This is a single-centre prospective cohort study conducted at Singapore General Hospital (SGH). Patients presenting to SGH ED from July 2011 to August 2012 were recruited. They were aged ≥ 21 years, with an estimated glomerular filtration rate < 60 mL/min/1.73 m2, and had congestive cardiac failure, systemic inflammatory response syndrome or required hospital admission. AKI was diagnosed by researchers blinded to experimental measurements. Serum NGAL was measured as a point-of-care test. Results: 784 patients were enrolled, of whom 107 (13.6%) had AKI. Mean serum NGAL levels were raised (p < 0.001) in patients with AKI (670.0 ± 431.9 ng/dL) compared with patients without AKI (490.3 ± 391.6 ng/dL). The sensitivity and specificity of NGAL levels > 490 ng/dL for AKI were 59% (95% confidence interval [CI] 49%–68%) and 65% (95% CI 61%–68%), respectively. Need for RRT increased 21% per 100 ng/dL increase in NGAL (p < 0.001), whereas odds of death in three months increased 10% per 100 ng/dL increase in NGAL (p = 0.028). No clear relationship was observed between NGAL levels and MACE. Conclusion: Serum NGAL identifies AKI and predicts three-month mortality.

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Neutrophil gelatinase associated lipocalin in predicting postoperative acute kidney injury in elderly

et al. 2021

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Predictive value of plasma neutrophil gelatinase‐associated lipocalin for acute kidney injury in intensive care unit patients after major non‐cardiac surgery

Abstract: pNGAL correlated with severity of AKI and requirement of renal replacement therapy in ICU patients who received major or ultra-major non-cardiac surgery. However, the benefit of adding pNGAL into clinical AKI prediction model is marginal.

Cited by 4 publications

References 30 publications

Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis

Biomarkers for prediction of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis

Neutrophil gelatinase-associated lipocalin: a biochemical marker for acute kidney injury and long-term outcomes in patients presenting to the emergency department

Neutrophil gelatinase associated lipocalin in predicting postoperative acute kidney injury in elderly

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