Neutrophil gelatinase-associated lipocalin.
OBJECTIVE
Acute kidney injury (AKI) is a major clinical problem in hospitalized patients. Effective treatment and early diagnosis of this syndrome are not currently available. This review focuses on recent studies examining the biological characteristics and the diagnostic and prognostic value of a novel biomarker--neutrophil gelatinase-associated lipocalin (NGAL)--in the two major patient populations at risk for AKI.


RESULTS
NGAL is one of the most intensively investigated novel renal biomarkers with promising data from animal experiments and clinical studies comprising more than 3500 cardiac surgery or critically ill patients. NGAL was discovered using unbiased transcriptomic approaches and was identified as the gene with the earliest and highest rise of mRNA and protein concentration in renal tissue, urine and plasma following various renal insults. Within minutes to a few hours after a renal insult, NGAL is induced in and released from the injured distal nephron. The average sensitivity and specificity of NGAL--measured 1-3 days prior to current AKI consensus diagnosis--was 76 and 77% respectively for cardiac surgery patients and 73 and 80% respectively for patients admitted to the intensive care unit.


CONCLUSIONS
NGAL appears to fulfill many characteristics of an appropriate 'real-time' biomarker for AKI detection.
Haase
Michael
M
Department of Nephrology and Intensive Care, Charité-University Medicine Berlin, Germany. michael.haase@charite.de
Bellomo
Rinaldo
R
Haase-Fielitz
Anja
A
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D000209:Acute-Phase Proteins / Q000378:metabolism* / Q000652:urine; D015415:Biomarkers; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016638:Critical Illness; D020869:Gene Expression Profiling; D006801:Humans; D007362:Intensive Care Units; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood / Q000378:metabolism* / Q000652:urine; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000097:blood / Q000378:metabolism* / Q000652:urine; D017582:Renal Replacement Therapy; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000652:urine; D013997:Time Factors
D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins