Neutrophil gelatinase-associated lipocalin as an early marker of acute kidney injury in patients with traumatic brain injury
| Autor: | Ning Li, Wei-Feng Zhang, Fu-Lin Xu, Wei-Guo Zhao, Wei-Ting Gu |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Traumatic brain injury Urinary system Urology Lipocalin urologic and male genital diseases Sensitivity and Specificity law.invention Lipocalin-2 law Proto-Oncogene Proteins Recoverin medicine Humans Prospective Studies Prospective cohort study Adverse effect business.industry Acute kidney injury Acute Kidney Injury Middle Aged medicine.disease Intensive care unit Lipocalins Cardiac surgery Surgery Intensive Care Units ROC Curve Nephrology Area Under Curve Brain Injuries Creatinine Female business Biomarkers Acute-Phase Proteins |
| Zdroj: | Journal of Nephrology. 26:1083-1088 |
| ISSN: | 1121-8428 |
| Popis: | Background: Recent studies have shown that urinary neutrophil gelatinase-associated lipocalin (NGAL) is rapidly up-regulated early after murine renal injury, and in patients after cardiac surgery or patients criti- cally ill with multiple trauma. In this study, we evalu- ated urinary NGAL levels as a potential biomarker of early acute kidney injury (AKI) in patients with severe traumatic brain injury (TBI). Methods: All patients with severe TBI admitted to our neurosurgical intensive care unit from March to September 2011 were enrolled prospectively. Urinary NGAL was measured using a chemiluminescent mic- roparticle immunoassay upon admission and at 24 and 48 hours after TBI. The presence of AKI was defined by the Acute Kidney Injury Network (AKIN) criteria. Results: Using AKIN criteria, a total of 13 patients were identified with AKI, an incidence of 24%. Those who subsequently developed AKI had a striking rise in urinary NGAL early after TBI and a sustained in- crease over the entire duration of the study. The uri- nary NGAL level of the AKI group was significantly higher than the group without AKI at all time points. Using a cutoff value of 53.9 ng/mL, the area under the receiver-operating characteristic curve for urinary NGAL at 48 hours was 0.876 with a sensitivity of 0.69 and specificity of 0.95. Conclusions: Increased urinary NGAL is associated with an increased occurrence of AKI in patients with severe TBI. It is possible that urinary NGAL could pro- vide a screening tool for AKI immediately after severe TBI, and this may in turn allow early intervention to ameliorate the adverse effects of AKI. |
| Databáze: | OpenAIRE |
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