title: Neutrophil gelatinase-associated lipocalin as a marker of acute renal disease.
abstract: OBJECTIVE
  Acute renal disease has major prognostic impact in hospitalized patients. Early diagnosis using renal function markers such as serum creatinine or urinary output and effective treatment are currently not possible. 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 patients at risk for acute renal disease.
  
  
  RESULTS
  NGAL levels increase early and proportional to the degree of renal injury in the urine and plasma. Here, we report the results of clinical studies where NGAL was measured in 325 patients with autoimmune and infectious diseases, those with cisplatin-associated nephrotoxicity, and more than 4000 patients at risk of acute kidney injury due to sepsis, cardiac surgery, exposure to contrast media, or after renal transplantation. Whenever renal damage occurred, as evidenced by histopathology or subsequent increase in serum creatinine levels, NGAL levels were higher than in patients without acute renal disease. An increase in NGAL substantially preceded clinical diagnosis of acute renal disease.
  
  
  CONCLUSIONS
  NGAL fulfills many characteristics of an appropriate 'real-time' renal biomarker. The data on NGAL could justify re-assessment of the concept and definition of acute kidney injury.
authors.affiliation: aDepartment of Nephrology and Intensive Care, Charité - University Medicine Berlin, Berlin, Germany bDepartment of Nephrology and Hypertension and Endocrinology and Metabolic Diseases, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany cDepartment of Intensive Care, Austin Hospital, Melbourne, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Haase
authors.forename: Anja
authors.initials: A
authors.lastname: Haase-Fielitz
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mertens
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000652:urine*; D015201:Meta-Analysis as Topic; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins