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2015 ; 15
(ä): 464
Nephropedia Template TP
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Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) and proteinuria predict
severity of acute kidney injury in Puumala virus infection
#MMPMID26503619
Bunz H
; Weyrich P
; Peter A
; Baumann D
; Tschritter O
; Guthoff M
; Beck R
; Jahn G
; Artunc F
; Häring HU
; Heyne N
; Wagner R
BMC Infect Dis
2015[Oct]; 15
(ä): 464
PMID26503619
show ga
BACKGROUND: Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with
renal syndrome (HFRS) that is caused by the Puumala virus. Periodic outbreaks
have been described in endemic areas, with a substantial number of previously
healthy individuals developing acute kidney injury (AKI). There is a considerable
diversity in the clinical course of the disease, and few patients require renal
replacement therapy. METHODS: We tested whether urinary neutrophil gelatinase
associated lipocalin (uNGAL), urine albumin/creatinine ratio (uACR), urine
protein/creatinine ratio (uPCR), urine dipstick protein, C-reactive protein,
procalcitonin, leukocyte and platelet count, determined on admission to the
hospital, can predict the severity of AKI. Sixty-one patients were analyzed
during admission in the emergency department. RESULTS: The variables most
strongly associated with peak plasma creatinine concentration were uNGAL (? =
0.70, p <0.0001), uPCR (? = 0.64, p = 0.001), uACR (? = 0.61, p = 0.002), and
dipstick proteinuria (? = 0.34, p = 0.008). The highest AUC-ROC to predict stage
3 AKI according to the acute kidney injury network's (AKIN) classification was
seen for uNGAL (0.81, p = 0.001). CONCLUSION: uNGAL accurately predicts the
severity of AKI in NE. This could help emergency room physicians predict disease
severity and allow for initial risk stratification.