NDLI: Plasma neutrophil gelatinase-associated lipocalin for the prediction of acute kidney injury in acute heart failure

Content Provider	Springer Nature : BioMed Central
Author	Breidthardt, Tobias Socrates, Thenral Drexler, Beatrice Noveanu, Markus Heinisch, Corinna Arenja, Nisha Klima, Theresia Züsli, Christina Reichlin, Tobias Potocki, Mihael Twerenbold, Raphael Steiger, Jürg Mueller, Christian
Abstract	Introduction The accurate prediction of acute kidney injury (AKI) in patients with acute heart failure (AHF) is an unmet clinical need. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel sensitive and specific marker of AKI. Methods A total of 207 consecutive patients presenting to the emergency department with AHF were enrolled. Plasma NGAL was measured in a blinded fashion at presentation and serially thereafter. The potential of plasma NGAL levels to predict AKI was assessed as the primary endpoint. We defined AKI according to the AKI Network classification. Results Overall 60 patients (29%) experienced AKI. These patients were more likely to suffer from pre-existing chronic cardiac or kidney disease. At presentation, creatinine (median 140 (interquartile range (IQR), 91 to 203) umol/L versus 97 (76 to 132) umol/L, P < 0.01) and NGAL (114.5 (IQR, 67.1 to 201.5) ng/ml versus 74.5 (60 to 113.9) ng/ml, P < 0.01) levels were significantly higher in AKI compared to non-AKI patients. The prognostic accuracy for measurements obtained at presentation, as quantified by the area under the receiver operating characteristic curve was mediocre and comparable for the two markers (creatinine 0.69; 95%CI 0.59 to 0.79 versus NGAL 0.67; 95%CI 0.57 to 0.77). Serial measurements of NGAL did not further increase the prognostic accuracy for AKI. Creatinine, but not NGAL, remained an independent predictor of AKI (hazard ratio (HR) 1.12; 95%CI 1.00 to 1.25; P = 0.04) in multivariable regression analysis. Conclusions Plasma NGAL levels do not adequately predict AKI in patients with AHF.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc10600.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc10600
Journal	Critical Care
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2012-01-07
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Acute Kidney Injury Acute Heart Failure Acute Kidney Injury Network Urinary NGAL NGAL Level
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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