title: Removal of neutrophil gelatinase-associated lipocalin by extracorporeal therapies.
abstract: Neutrophil gelatinase-associated lipocalin (NGAL) protein is an early biomarker for acute kidney injury (AKI). It is unknown if extracorporeal therapies (EC) have an effect on circulating NGAL levels. This study was designed to describe the kinetics of NGAL molecule in different EC techniques and to evaluate NGAL clearance in different operational conditions. A mock hemofiltration (HF) and hemoperfusion (HP) setup was used. NGAL was added to the blood reservoir and then measured at 30-minute intervals from arterial, venous, and ultrafiltrate (UF) lines. Removal kinetics and NGAL sieving coefficient were calculated. In our experiments, baseline NGAL concentration averaged 452 microg/L. There was a consistent downward trend throughout the experiment. NGAL concentration in the UF was between 80 and 90 microg/L, though it showed a slight increase in the second hour. The sieving coefficient of NGAL ranged from 0.2 to 0.4 during HF and it appeared to increase with time, suggesting an initial effect of membrane adsorption. HP proved clearly that there was adsorption of NGAL by the membrane and the point of saturation occured at approximately 60 minutes from the start of circulation. Our evaluation demonstrates that NGAL can be adsorbed and ultrafiltrated with polysulfone membranes. This should be taken into consideration when using NGAL as an AKI biomarker in patients undergoing EC circulation.
authors.affiliation: Department of Nephrology, St. Bortolo Hospital, Vicenza, Italy.
authors.forename: Ilona
authors.initials: I
authors.lastname: Bobek
authors.forename: Dehua
authors.initials: D
authors.lastname: Gong
authors.forename: Massimo
authors.initials: M
authors.lastname: De Cal
authors.forename: Dinna
authors.initials: D
authors.lastname: Cruz
authors.forename: Chang Y
authors.initials: CY
authors.lastname: Chionh
authors.forename: Mikko
authors.initials: M
authors.lastname: Haapio
authors.forename: Sachin S
authors.initials: SS
authors.lastname: Soni
authors.forename: Federico
authors.initials: F
authors.lastname: Nalesso
authors.forename: Paolo
authors.initials: P
authors.lastname: Lentini
authors.forename: Francesco
authors.initials: F
authors.lastname: Garzotto
authors.forename: Valentina
authors.initials: V
authors.lastname: Corradi
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000628:therapy*; D000209:Acute-Phase Proteins / Q000302:isolation & purification*; D015415:Biomarkers / Q000097:blood; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods*; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D066298:In Vitro Techniques; D007700:Kinetics; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000302:isolation & purification*; D008954:Models, Biological; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000302:isolation & purification*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins