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2017 ; 7
(2
): 62-77
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Urinary Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Acute Kidney
Injury, Severe Kidney Injury, and the Need for Renal Replacement Therapy in the
Intensive Care Unit
#MMPMID28868069
Albeladi FI
; Algethamy HM
Nephron Extra
2017[May]; 7
(2
): 62-77
PMID28868069
show ga
BACKGROUND: Recent attempts were made to identify early indicators of acute
kidney injury (AKI) in order to accelerate treatment and hopefully improve
outcomes. This study aims to assess the value of urinary neutrophil
gelatinase-associated lipocalin (uNGAL) as a predictor of AKI, severe AKI, and
the need for renal replacement therapy (RRT). METHODS: We conducted a prospective
study and included adults admitted to our intensive care unit (ICU) at King
Abdulaziz University Hospital (KAUH), between May 2012 and June 2013, who had at
least 1 major risk factor for AKI. They were followed up throughout their
hospital stay to identify which potential characteristics predicted any of the
above 3 outcomes. We collected information on patients' age and gender, the Acute
Physiology And Chronic Health Evaluation, version II (APACHE II) score, the
Sepsis-Related Organ Failure Assessment (SOFA) score, serum creatinine and
cystatin C levels, and uNGAL. We compared ICU patients who presented with any of
the 3 outcomes with others who did not. RESULTS: We included 75 patients, and
among those 21 developed AKI, 18 severe AKI, and 17 required RRT. Bivariate
analysis revealed intergroup differences for almost all clinical variables (e.g.,
patients with AKI vs. patients without AKI); while multivariate analysis
identified mean arterial pressure as the only predictor for AKI (p < 0.001) and
the SOFA score (p = 0.04) as the only predictor for severe AKI. For RRT, day 1
maximum uNGAL was the stronger predictor (p < 0.001) when compared to admission
diagnosis (p = 0.014). Day 1 and day 2 maximum uNGAL levels were good and
excellent predictors for future RRT, but only fair to good predictors for AKI and
severe AKI. CONCLUSIONS: Maximum urine levels of uNGAL measured over the first
and second 24 h of an ICU admission were highly accurate predictors of the future
need for RRT, however less accurate at detecting early and severe AKI.