title: The use of plasma and urine neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C in early diagnosis of septic acute kidney injury in critically ill patients.
abstract: OBJECTIVE
  To assess and compare the roles of plasma and urine concentrations of neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C for early diagnosis of septic acute kidney injury (AKI) in adult critically ill patients.
  
  
  METHODS
  Patients were divided into three groups as sepsis-non AKI, sepsis-AKI and non sepsis-non AKI. Plasma samples for NGAL and Cystatin C were determined on admission and on alternate days and urinary samples were collected for every day until ICU discharge.
  
  
  RESULTS
  One hundred fifty one patients were studied; 66 in sepsis-non AKI, 63 in sepsis-AKI, 22 in non-sepsis-non-AKI groups. Although plasma NGAL performed less well (AUC 0.44), urinary NGAL showed significant discrimination for AKI diagnosis (AUC 0.80) with a threshold value of 29.5 ng/ml (88% sensitivity, 73% specificity). Both plasma and urine Cystatin C worked well for the diagnosis of AKI (AUC 0.82 and 0.86, thresholds 1.5 and 0.106 mg/L respectively).
  
  
  CONCLUSIONS
  Plasma and urinary Cystatin C and urinary NGAL are useful markers in predicting AKI in septic critically ill patients. Plasma NGAL raises in patients with sepsis in the absence of AKI and should be used with caution as a marker of AKI in septic ICU patients.
authors: Department of Pulmonary Critical Care Medicine, Gazi University School of Medicine, Ankara, Turkey. mugeaydogdu@yahoo.com
authors: Müge
authors: M
authors: Aydoğdu
authors: Gül
authors: G
authors: Gürsel
authors: Banu
authors: B
authors: Sancak
authors: Serpil
authors: S
authors: Yeni
authors: Gülçin
authors: G
authors: Sarı
authors: Seçil
authors: S
authors: Taşyürek
authors: Murat
authors: M
authors: Türk
authors: Seher
authors: S
authors: Yüksel
authors: Mehmet
authors: M
authors: Senes
authors: Türkan Nadir
authors: TN
authors: Ozis
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000175:diagnosis*; D000209:Acute-Phase Proteins / Q000032:analysis* / Q000652:urine; D000368:Aged; D016638:Critical Illness; D055316:Cystatin C / Q000032:analysis* / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000032:analysis* / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000032:analysis* / Q000097:blood / Q000652:urine; D018805:Sepsis / Q000150:complications / Q000175:diagnosis*
chemical_list: D000209:Acute-Phase Proteins; C525030:CST3 protein, human; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins