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10.1186/s12876-015-0372-5

http://scihub22266oqcxt.onion/10.1186/s12876-015-0372-5
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suck abstract from ncbi


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pmid26474856
      BMC+Gastroenterol 2015 ; 15 (ä): 140
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  • Urine neutrophil gelatinase-associated lipocalin: a diagnostic and prognostic marker for acute kidney injury (AKI) in hospitalized cirrhotic patients with AKI-prone conditions #MMPMID26474856
  • Treeprasertsuk S ; Wongkarnjana A ; Jaruvongvanich V ; Sallapant S ; Tiranathanagul K ; Komolmit P ; Tangkijvanich P
  • BMC Gastroenterol 2015[Oct]; 15 (ä): 140 PMID26474856 show ga
  • BACKGROUND: Acute kidney injury (AKI) is known to increase mortality in hospitalized cirrhotic patients; therefore early identification is utmost significance. There are only a few studies evaluating the cut-off level of urine neutrophil gelatinase-associated lipocalin (uNGAL) for diagnosing AKI and its prognostic value in cirrhotic patients. We aimed to determine the accuracy of uNGAL as a biomarker for early identification of AKI and to determine the cut-off level of uNGAL for diagnosing AKI in hospitalized cirrhotic patients; and (2) to explore the association of 30-day liver-related mortality with uNGAL level. METHODS AND MATERIAL: We prospectively enrolled cirrhotic patients admitted at the King Chulalongkorn Memorial Hospital during May 1, 2011 to Dec 31, 2013. UNGAL levels were measured within 24 h after admission. Clinical and laboratory data were obtained. Patients were followed up to 30 days. RESULTS: Of 137 cirrhotic hospitalized patients, 121 cirrhotic patients (88.3 %) with AKI-prone conditions were included with mean age of 57.3?±?14.7 years. Thirty-five patients (29 %) developed AKI within 72 h of admission. The causes of AKI were prerenal azotemia (68.6 %), acute tubular necrosis (25.7 %), hepatorenal syndrome (5.7 %), respectively. The mean uNGAL level was significantly higher in the patients who developed AKI compared with those who did not (290.6?±?356.3 vs. 54.4?±?73.7 ng/mL; P?=?0.0001). The AUC of uNGAL for diagnosing AKI was 0.83 (95 % [CI]: 0.76-0.91) with the optimal cut-off level of 56 ng/mL, providing 77.1 % sensitivity and 73.3 % specificity. Fourteen percent of subjects died during the 30-day follow-up period. The mean uNGAL levels were significantly higher in the mortality group. The AUC of uNGAL in predicting mortality was 0.75 (95 % [CI]: 0.66-0.85), with a best cut-off level of 72 ng/mL providing 70.6 % sensitivity and 69.2 % specificity. However, in multivariate logistic regression analysis, uNGAL is not an independent factor for 30-day liver-related mortality prediction. CONCLUSIONS: uNGAL is a valid marker for the early detection of AKI in hospitalized cirrhotic patients with AKI-prone conditions; however, its level could not independently predict 30-day liver-related mortality.
  • |Acute Kidney Injury/*diagnosis/etiology [MESH]
  • |Acute-Phase Proteins/*urine [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Area Under Curve [MESH]
  • |Biomarkers/urine [MESH]
  • |Early Diagnosis [MESH]
  • |Female [MESH]
  • |Hospitalization [MESH]
  • |Humans [MESH]
  • |Lipocalin-2 [MESH]
  • |Lipocalins/*urine [MESH]
  • |Liver Cirrhosis/complications/mortality/*urine [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Predictive Value of Tests [MESH]
  • |Prognosis [MESH]
  • |Prospective Studies [MESH]
  • |Proto-Oncogene Proteins/*urine [MESH]


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