Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury
Purpose To study the impact of inflammation/sepsis on the concentrations of neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine in adult intensive care unit (ICU) patients and to estimate the predictive properties of NGAL in plasma and urine for early detection of acute kidney inju...
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| Veröffentlicht in: | Intensive care medicine 2010-08, Vol.36 (8), p.1333-1340 |
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| creator | Mårtensson, Johan Bell, Max Oldner, Anders Xu, Shengyuan Venge, Per Martling, Claes-Roland |
| description | Purpose
To study the impact of inflammation/sepsis on the concentrations of neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine in adult intensive care unit (ICU) patients and to estimate the predictive properties of NGAL in plasma and urine for early detection of acute kidney injury (AKI) in patients with septic shock.
Methods
Sixty-five patients admitted to the general ICU at the Karolinska University Hospital Solna, Sweden, with normal plasma creatinine were assessed for eligibility. Twenty-seven patients with systemic inflammatory response syndrome (SIRS), severe sepsis, or septic shock without AKI and 18 patients with septic shock and concomitant AKI were included in the final analysis. Plasma and urine were analyzed twice daily for plasma NGAL (pNGAL), C-reactive protein (CRP), procalcitonin, myeloperoxidase, plasma cystatin C, plasma creatinine, urine NGAL (uNGAL), urine cystatin C, and urine α1-microglobulin.
Results
Of the 45 patients, 40 had elevated peak levels of pNGAL. Peak levels of pNGAL were not significantly different between septic shock patients with and without AKI. Peak levels of uNGAL were below the upper reference limit in all but four patients without AKI. uNGAL was a good predictor (area under ROC 0.86) whereas pNGAL was a poor predictor (area under ROC 0.67) for AKI within the next 12 h in patients with septic shock.
Conclusions
pNGAL is raised in patients with SIRS, severe sepsis, and septic shock and should be used with caution as a marker of AKI in ICU patients with septic shock. uNGAL is more useful in predicting AKI as the levels are not elevated in septic patients without AKI. |
| doi_str_mv | 10.1007/s00134-010-1887-4 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_551950</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A724337698</galeid><sourcerecordid>A724337698</sourcerecordid><originalsourceid>FETCH-LOGICAL-c612t-87532b723434aa8a76b05025b4c3a698028d55b007c3dd3ebb0a1489fea30fe13</originalsourceid><addsrcrecordid>eNqFkl1vFCEUhidGY2v1B3hjJhrjjVP5HJjLTf1MGr1RbwnDnNllOwsjH2n238u6azc1bQwkHOB5gXN4q-o5RucYIfEuIoQpaxBGDZZSNOxBdYoZJQ0mVD6sThFlpGEtIyfVkxjXhRYtx4-rE4JoJxCip9XqK-QU_LyyU72ESSfrdIRGx-iN1QmGerKzN3qyri5dD3lKdYQ5WVPPhQaXYn1t06rWbvgT-JxqbXKC-soODrZFts5h-7R6NOopwrPDeFb9-Pjh-8Xn5vLbpy8Xi8vGtJikRgpOSS8IZZRpLbVoe8QR4T0zVLedREQOnPcle0OHgULfI42Z7EbQFI2A6VnV7M-N1zDnXs3BbnTYKq-tOixdlQgU57jjqPBv7-Xf258L5cNS5aww5ZK0BX-zx-fgf2WISW1sNDBN2oHPUQnOZCsFEf8nKW05bcXuyS__Idc-B1eqpFrUdeVeuYNe7aGlnkBZN_oUtNkdqRaCMEpFqc4x-1vUEhwEPXkHoy3Lt_jzO_jSBthYc6cA7wUm-BgDjDcFw0jtTKn2plRoNy-mVKxoXhzyy_0GhhvFXxcW4PUB0LFYbQzaGRuPHEVUErL7K3L4q7LllhCOhbr_9t8voffw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>609958281</pqid></control><display><type>article</type><title>Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Mårtensson, Johan ; Bell, Max ; Oldner, Anders ; Xu, Shengyuan ; Venge, Per ; Martling, Claes-Roland</creator><creatorcontrib>Mårtensson, Johan ; Bell, Max ; Oldner, Anders ; Xu, Shengyuan ; Venge, Per ; Martling, Claes-Roland</creatorcontrib><description>Purpose
To study the impact of inflammation/sepsis on the concentrations of neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine in adult intensive care unit (ICU) patients and to estimate the predictive properties of NGAL in plasma and urine for early detection of acute kidney injury (AKI) in patients with septic shock.
Methods
Sixty-five patients admitted to the general ICU at the Karolinska University Hospital Solna, Sweden, with normal plasma creatinine were assessed for eligibility. Twenty-seven patients with systemic inflammatory response syndrome (SIRS), severe sepsis, or septic shock without AKI and 18 patients with septic shock and concomitant AKI were included in the final analysis. Plasma and urine were analyzed twice daily for plasma NGAL (pNGAL), C-reactive protein (CRP), procalcitonin, myeloperoxidase, plasma cystatin C, plasma creatinine, urine NGAL (uNGAL), urine cystatin C, and urine α1-microglobulin.
Results
Of the 45 patients, 40 had elevated peak levels of pNGAL. Peak levels of pNGAL were not significantly different between septic shock patients with and without AKI. Peak levels of uNGAL were below the upper reference limit in all but four patients without AKI. uNGAL was a good predictor (area under ROC 0.86) whereas pNGAL was a poor predictor (area under ROC 0.67) for AKI within the next 12 h in patients with septic shock.
Conclusions
pNGAL is raised in patients with SIRS, severe sepsis, and septic shock and should be used with caution as a marker of AKI in ICU patients with septic shock. uNGAL is more useful in predicting AKI as the levels are not elevated in septic patients without AKI.</description><identifier>ISSN: 0342-4642</identifier><identifier>ISSN: 1432-1238</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-010-1887-4</identifier><identifier>PMID: 20397003</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Acute Kidney Injury - diagnosis ; Acute Kidney Injury - physiopathology ; Acute-Phase Proteins - metabolism ; Acute-Phase Proteins - urine ; Adult ; AKI ; Analysis ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Biomarkers ; Biomarkers - blood ; C-reactive protein ; Cardiology. Vascular system ; Coronary heart disease ; Creatinine ; Critical Care Medicine ; Critical Illness ; Cystatin C ; Early Diagnosis ; Emergency Medicine ; Female ; Heart ; HNL ; Hospital patients ; Humans ; Infection ; Intensive ; Intensive care ; Intensive care medicine ; Kidneys ; Lipocalin-2 ; Lipocalins - blood ; Lipocalins - metabolism ; Lipocalins - urine ; Male ; Medical research ; Medical sciences ; MEDICIN ; MEDICINE ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Neutrophils ; NGAL ; Original ; Pain Medicine ; Pediatrics ; Plasma ; Pneumology/Respiratory System ; Predictive Value of Tests ; Proto-Oncogene Proteins - blood ; Proto-Oncogene Proteins - metabolism ; Proto-Oncogene Proteins - urine ; RIFLE ; Sensitivity and Specificity ; Sepsis ; Sepsis - metabolism ; Septic shock ; Urine</subject><ispartof>Intensive care medicine, 2010-08, Vol.36 (8), p.1333-1340</ispartof><rights>Copyright jointly held by Springer and ESICM 2010</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2010 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c612t-87532b723434aa8a76b05025b4c3a698028d55b007c3dd3ebb0a1489fea30fe13</citedby><cites>FETCH-LOGICAL-c612t-87532b723434aa8a76b05025b4c3a698028d55b007c3dd3ebb0a1489fea30fe13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-010-1887-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-010-1887-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23038220$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20397003$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-135826$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:120961942$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Mårtensson, Johan</creatorcontrib><creatorcontrib>Bell, Max</creatorcontrib><creatorcontrib>Oldner, Anders</creatorcontrib><creatorcontrib>Xu, Shengyuan</creatorcontrib><creatorcontrib>Venge, Per</creatorcontrib><creatorcontrib>Martling, Claes-Roland</creatorcontrib><title>Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Purpose
To study the impact of inflammation/sepsis on the concentrations of neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine in adult intensive care unit (ICU) patients and to estimate the predictive properties of NGAL in plasma and urine for early detection of acute kidney injury (AKI) in patients with septic shock.
Methods
Sixty-five patients admitted to the general ICU at the Karolinska University Hospital Solna, Sweden, with normal plasma creatinine were assessed for eligibility. Twenty-seven patients with systemic inflammatory response syndrome (SIRS), severe sepsis, or septic shock without AKI and 18 patients with septic shock and concomitant AKI were included in the final analysis. Plasma and urine were analyzed twice daily for plasma NGAL (pNGAL), C-reactive protein (CRP), procalcitonin, myeloperoxidase, plasma cystatin C, plasma creatinine, urine NGAL (uNGAL), urine cystatin C, and urine α1-microglobulin.
Results
Of the 45 patients, 40 had elevated peak levels of pNGAL. Peak levels of pNGAL were not significantly different between septic shock patients with and without AKI. Peak levels of uNGAL were below the upper reference limit in all but four patients without AKI. uNGAL was a good predictor (area under ROC 0.86) whereas pNGAL was a poor predictor (area under ROC 0.67) for AKI within the next 12 h in patients with septic shock.
Conclusions
pNGAL is raised in patients with SIRS, severe sepsis, and septic shock and should be used with caution as a marker of AKI in ICU patients with septic shock. uNGAL is more useful in predicting AKI as the levels are not elevated in septic patients without AKI.</description><subject>Acute Kidney Injury - diagnosis</subject><subject>Acute Kidney Injury - physiopathology</subject><subject>Acute-Phase Proteins - metabolism</subject><subject>Acute-Phase Proteins - urine</subject><subject>Adult</subject><subject>AKI</subject><subject>Analysis</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthesiology</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>C-reactive protein</subject><subject>Cardiology. Vascular system</subject><subject>Coronary heart disease</subject><subject>Creatinine</subject><subject>Critical Care Medicine</subject><subject>Critical Illness</subject><subject>Cystatin C</subject><subject>Early Diagnosis</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Heart</subject><subject>HNL</subject><subject>Hospital patients</subject><subject>Humans</subject><subject>Infection</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Intensive care medicine</subject><subject>Kidneys</subject><subject>Lipocalin-2</subject><subject>Lipocalins - blood</subject><subject>Lipocalins - metabolism</subject><subject>Lipocalins - urine</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>MEDICIN</subject><subject>MEDICINE</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Neutrophils</subject><subject>NGAL</subject><subject>Original</subject><subject>Pain Medicine</subject><subject>Pediatrics</subject><subject>Plasma</subject><subject>Pneumology/Respiratory System</subject><subject>Predictive Value of Tests</subject><subject>Proto-Oncogene Proteins - blood</subject><subject>Proto-Oncogene Proteins - metabolism</subject><subject>Proto-Oncogene Proteins - urine</subject><subject>RIFLE</subject><subject>Sensitivity and Specificity</subject><subject>Sepsis</subject><subject>Sepsis - metabolism</subject><subject>Septic shock</subject><subject>Urine</subject><issn>0342-4642</issn><issn>1432-1238</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkl1vFCEUhidGY2v1B3hjJhrjjVP5HJjLTf1MGr1RbwnDnNllOwsjH2n238u6azc1bQwkHOB5gXN4q-o5RucYIfEuIoQpaxBGDZZSNOxBdYoZJQ0mVD6sThFlpGEtIyfVkxjXhRYtx4-rE4JoJxCip9XqK-QU_LyyU72ESSfrdIRGx-iN1QmGerKzN3qyri5dD3lKdYQ5WVPPhQaXYn1t06rWbvgT-JxqbXKC-soODrZFts5h-7R6NOopwrPDeFb9-Pjh-8Xn5vLbpy8Xi8vGtJikRgpOSS8IZZRpLbVoe8QR4T0zVLedREQOnPcle0OHgULfI42Z7EbQFI2A6VnV7M-N1zDnXs3BbnTYKq-tOixdlQgU57jjqPBv7-Xf258L5cNS5aww5ZK0BX-zx-fgf2WISW1sNDBN2oHPUQnOZCsFEf8nKW05bcXuyS__Idc-B1eqpFrUdeVeuYNe7aGlnkBZN_oUtNkdqRaCMEpFqc4x-1vUEhwEPXkHoy3Lt_jzO_jSBthYc6cA7wUm-BgDjDcFw0jtTKn2plRoNy-mVKxoXhzyy_0GhhvFXxcW4PUB0LFYbQzaGRuPHEVUErL7K3L4q7LllhCOhbr_9t8voffw</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Mårtensson, Johan</creator><creator>Bell, Max</creator><creator>Oldner, Anders</creator><creator>Xu, Shengyuan</creator><creator>Venge, Per</creator><creator>Martling, Claes-Roland</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DF2</scope></search><sort><creationdate>20100801</creationdate><title>Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury</title><author>Mårtensson, Johan ; Bell, Max ; Oldner, Anders ; Xu, Shengyuan ; Venge, Per ; Martling, Claes-Roland</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c612t-87532b723434aa8a76b05025b4c3a698028d55b007c3dd3ebb0a1489fea30fe13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Acute Kidney Injury - diagnosis</topic><topic>Acute Kidney Injury - physiopathology</topic><topic>Acute-Phase Proteins - metabolism</topic><topic>Acute-Phase Proteins - urine</topic><topic>Adult</topic><topic>AKI</topic><topic>Analysis</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthesiology</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>C-reactive protein</topic><topic>Cardiology. Vascular system</topic><topic>Coronary heart disease</topic><topic>Creatinine</topic><topic>Critical Care Medicine</topic><topic>Critical Illness</topic><topic>Cystatin C</topic><topic>Early Diagnosis</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Heart</topic><topic>HNL</topic><topic>Hospital patients</topic><topic>Humans</topic><topic>Infection</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Intensive care medicine</topic><topic>Kidneys</topic><topic>Lipocalin-2</topic><topic>Lipocalins - blood</topic><topic>Lipocalins - metabolism</topic><topic>Lipocalins - urine</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>MEDICIN</topic><topic>MEDICINE</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Neutrophils</topic><topic>NGAL</topic><topic>Original</topic><topic>Pain Medicine</topic><topic>Pediatrics</topic><topic>Plasma</topic><topic>Pneumology/Respiratory System</topic><topic>Predictive Value of Tests</topic><topic>Proto-Oncogene Proteins - blood</topic><topic>Proto-Oncogene Proteins - metabolism</topic><topic>Proto-Oncogene Proteins - urine</topic><topic>RIFLE</topic><topic>Sensitivity and Specificity</topic><topic>Sepsis</topic><topic>Sepsis - metabolism</topic><topic>Septic shock</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mårtensson, Johan</creatorcontrib><creatorcontrib>Bell, Max</creatorcontrib><creatorcontrib>Oldner, Anders</creatorcontrib><creatorcontrib>Xu, Shengyuan</creatorcontrib><creatorcontrib>Venge, Per</creatorcontrib><creatorcontrib>Martling, Claes-Roland</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Uppsala universitet</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mårtensson, Johan</au><au>Bell, Max</au><au>Oldner, Anders</au><au>Xu, Shengyuan</au><au>Venge, Per</au><au>Martling, Claes-Roland</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>36</volume><issue>8</issue><spage>1333</spage><epage>1340</epage><pages>1333-1340</pages><issn>0342-4642</issn><issn>1432-1238</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>Purpose
To study the impact of inflammation/sepsis on the concentrations of neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine in adult intensive care unit (ICU) patients and to estimate the predictive properties of NGAL in plasma and urine for early detection of acute kidney injury (AKI) in patients with septic shock.
Methods
Sixty-five patients admitted to the general ICU at the Karolinska University Hospital Solna, Sweden, with normal plasma creatinine were assessed for eligibility. Twenty-seven patients with systemic inflammatory response syndrome (SIRS), severe sepsis, or septic shock without AKI and 18 patients with septic shock and concomitant AKI were included in the final analysis. Plasma and urine were analyzed twice daily for plasma NGAL (pNGAL), C-reactive protein (CRP), procalcitonin, myeloperoxidase, plasma cystatin C, plasma creatinine, urine NGAL (uNGAL), urine cystatin C, and urine α1-microglobulin.
Results
Of the 45 patients, 40 had elevated peak levels of pNGAL. Peak levels of pNGAL were not significantly different between septic shock patients with and without AKI. Peak levels of uNGAL were below the upper reference limit in all but four patients without AKI. uNGAL was a good predictor (area under ROC 0.86) whereas pNGAL was a poor predictor (area under ROC 0.67) for AKI within the next 12 h in patients with septic shock.
Conclusions
pNGAL is raised in patients with SIRS, severe sepsis, and septic shock and should be used with caution as a marker of AKI in ICU patients with septic shock. uNGAL is more useful in predicting AKI as the levels are not elevated in septic patients without AKI.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>20397003</pmid><doi>10.1007/s00134-010-1887-4</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0342-4642 |
| ispartof | Intensive care medicine, 2010-08, Vol.36 (8), p.1333-1340 |
| issn | 0342-4642 1432-1238 1432-1238 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Acute Kidney Injury - diagnosis Acute Kidney Injury - physiopathology Acute-Phase Proteins - metabolism Acute-Phase Proteins - urine Adult AKI Analysis Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthesiology Biological and medical sciences Biomarkers Biomarkers - blood C-reactive protein Cardiology. Vascular system Coronary heart disease Creatinine Critical Care Medicine Critical Illness Cystatin C Early Diagnosis Emergency Medicine Female Heart HNL Hospital patients Humans Infection Intensive Intensive care Intensive care medicine Kidneys Lipocalin-2 Lipocalins - blood Lipocalins - metabolism Lipocalins - urine Male Medical research Medical sciences MEDICIN MEDICINE Medicine & Public Health Medicine, Experimental Middle Aged Neutrophils NGAL Original Pain Medicine Pediatrics Plasma Pneumology/Respiratory System Predictive Value of Tests Proto-Oncogene Proteins - blood Proto-Oncogene Proteins - metabolism Proto-Oncogene Proteins - urine RIFLE Sensitivity and Specificity Sepsis Sepsis - metabolism Septic shock Urine |
| title | Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury |
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