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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

12 Issues per year


IMPACT FACTOR 2016: 3.432

CiteScore 2016: 2.21

SCImago Journal Rank (SJR) 2016: 1.000
Source Normalized Impact per Paper (SNIP) 2016: 1.112

Online
ISSN
1437-4331
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Volume 47, Issue 1 (Jan 2009)

Issues

Urinary neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of acute kidney injury in critically ill multiple trauma patients

Konstantinos Makris
  • 1Clinical Biochemistry Department, KAT General Hospital, Kiffissia, Athens, Greece
/ Nikos Markou
  • 2University of Athens, Intensive Care Unit, KAT General Hospital, Kiffissia, Athens, Greece
/ Effimia Evodia
  • 3University of Athens, Intensive Care Unit, KAT General Hospital, Kiffissia, Athens, Greece
/ Eleni Dimopoulou
  • 4University of Athens, Intensive Care Unit, KAT General Hospital, Kiffissia, Athens, Greece
/ Ioannis Drakopoulos
  • 5Clinical Biochemistry Department, KAT General Hospital, Kiffissia, Athens, Greece
/ Konstantina Ntetsika
  • 6Clinical Biochemistry Department, KAT General Hospital, Kiffissia, Athens, Greece
/ Demetrios Rizos
  • 7University of Athens, Hormone Laboratory, Aretaieion Hospital, Athens, Greece
/ George Baltopoulos
  • 8University of Athens, Intensive Care Unit, KAT General Hospital, Kiffissia, Athens, Greece
/ Alexander Haliassos
  • 9Diamedica SA, Athens, Greece
Published Online: 2008-12-05 | DOI: https://doi.org/10.1515/CCLM.2009.004

Abstract

Background: Neutrophil gelatinase-associated lipocalin (NGAL), an iron-transporting protein rapidly accumulating in the kidney tubules and urine after nephrotoxic and ischemic insults, has been put forward as an early, sensitive, non-invasive biomarker for acute kidney injury (AKI). The aim of this study was to evaluate urinary NGAL levels as a predictor of early AKI (first 5 days after injury) in multi-trauma patients.

Methods: We studied multi-trauma adult patients admitted to the intensive care unit of a trauma hospital. Exclusion criteria were a) known cardiac or chronic kidney disease, and b) initial evaluation after more than 24 h had elapsed from injury. Urinary NGAL was measured using an ELISA technique upon admission and at 24 and 48 h. Presence of AKI was defined by the risk injury failure loss and end-stage kidney classification (RIFLE) criteria. Data are reported as median and interquartile range.

Results: A total of 31 patients (25 male, 6 female) were studied. NGAL levels at admission were significantly higher among patients who subsequently developed AKI [155.5 (50.5–205.9) ng/mL vs. 8.0 (5.7–17.7) ng/mL, p=0.0000] and these higher levels persisted over the following 2 days. On the basis of receiver-operating characteristic analysis both NGAL and serum creatinine baseline measurements could predict AKI [area under the curve (95% confidence interval) 0.977 (0.823–0.980) and 0.789 (0.556–0.906), respectively], but the area under the curve for NGAL was significantly larger (p=0.024). A cut-off point >25 ng/mL for NGAL had a sensitivity of 0.91 and specificity of 0.95 in predicting AKI.

Conclusions: Urinary NGAL can be used from the 1st day of injury as a reliable predictor of early AKI in multi-trauma patients.

Clin Chem Lab Med 2009;47:79–82.

Keywords: acute kidney injury; acute renal failure; multi-trauma patients; neutrophil gelatinase-associated lipocalin (NGAL)

About the article

Corresponding author: Dr. Konstantinos Makris, Clinical Biochemistry Department, KAT General Hospital, 2, Nikis Street, 14561 Kifissia, Athens, Greece Phone: +30-210-4961075, Fax: +30-210-9674137,


Received: 2008-08-20

Accepted: 2008-09-15

Published Online: 2008-12-05

Published Online: 2008-12-05

Published in Print: 2009-01-01


Citation Information: Clinical Chemistry and Laboratory Medicine, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2009.004.

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