NGAL as a marker of acute kidney injury in sepsis
V.Kh. Sharipova, N.F. Berdiev, O. K. Lutfullaev, M.I. Zhabborova
Republican Scientific Center for Emergency Medical Aid, Tashkent, Uzbekistan
Background. Acute kidney injury (AKI) can develop in a variety of conditions, especially in critically ill patients, and is often diagnosed late or remains undiagnosed. Clinical syptoms and routine laboratory parameters such as urine output and serum creatinine levels are late signs of kidney injury. The study and implementation into practice of new markers with high specificity at the early stages of kidney injury is an imperative of the time. The neutrophil gelatinase associated lipocalin (NGAL) is one of such markers.
Objective. Evaluation of the diagnostic and prognostic value of blood NGAL level in patients with septic shock.
Material and methods. 76 patients (45 men and 31 women, mean age 59.4 ± 6.2 years), diagnosed with sepsis of various etiology, were examined. AKI was diagnosed according to the KDIGO (Kidney Disease Improving Global Outcomes) criteria. Serum NGAL (sNGAL) levels were determined in patients at admission to the intensive care unit and 6, 24, 36 hours after. To analyze the predictive ability of NGAL, the binary logistic regression method and the AUC (area under curve) calculation was used.
Results. The sNGAL level in AKI patients was statistically significantly higher - 172.4 (129.1–257.7) than in patients without AKI - 124.3 (93.8–151.5) pg/ml (P <0, 05). ROC analysis revealed that the NGAL level of 148.5 pg/ml defined as the "cut-off value" allows predicting the development of AKI in septic patients. The AOC was 0.85 (95% CI, 0.63–0.95) with a sensitivity of 72.7% and a specificity of 86.1%.
Conclusions. The NGAL level can be used as a biomarker for the early detection of AKI in septic patients.
About the Autors
Visolat Kh. Sharipova – Dr.Sci (Med.), Head of the Department of Anesthesiology and Emergency Care, Republican Scientific Center for Emergency Medical Aid, Tashkent, Uzbekistan
Nodirbek F. Berdiev – Intensivist at the Surgical Intensive Care Unit, Republican Scientific Center for Emergency Medical Aid, Tashkent, Uzbekistan. Nodiranes52@gmail.com.
Odilkhon K. Lutfillaev - Intensivist at the Surgical Intensive Care Unit, Republican Scientific Center for Emergency Medical Aid, Tashkent, Uzbekistan
Mamura I. Zhabborova – Teaching Assistant of the Department of Normal and Pathological Physiology, Tashkent Medical Academy, Tashkent, Uzbekistan