Urinary neutrophil gelatinase-associated lipocalin for diagnosis of spontaneous bacterial peritonitis

Abstract

Cirrhotic patients with ascites are at high risk of developing spontaneous bacterial peritonitis (SBP). After exclusion of patients with acute kidney injury (AKI) or other infections, urinary neutrophil gelatinase-associated lipocalin (NGAL) levels were compared between two matched groups of Egyptian cirrhotic patients with ascites, mostly secondary to hepatitis C infection (98%). Group 1 had SBP (n = 41) and group 2 did not (n = 45). By univariate analysis, urinary-NGAL, high total bilirubin, serum creatinine, international normalised ratio and the Model of End-Stage Liver Disease (MELD) score and low platelet count were all significantly correlated with the presence of SBP, but only urinary-NGAL could independently predict development of SBP ( P = 0.001). Urinary-NGAL at a cut-off value of 1225 pg/mL, showed a sensitivity of 95% and a specificity of 76%, and is therefore a most useful tool.

Ascitic calprotectin as a useful marker in the diagnosis of spontaneous bacterial peritonitis in adults

“…In the case of SBP diagnosis, inoculation of bedside 10 mL of ascitic fluid into a blood culture bottle was done [2,4]. Patients with SBP [8] underwent immediate treatment with 3 rd generation cephalosporin and follow up ascitic fluid PMN 48 h after the start of treatment [4].…”

“…Studies were conducted on alternatives of the ascitic PMN count as high sensitivity C-reactive protein (hsCRP) [6], serum procalcitonin [7], urinary lipocalin [8], ascitic lactoferrin [9], homocysteine [10] and fecal or ascitic calprotectin [11,12].…”