title: [Plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL) predicts acute kidney injury in septic shock at ICU admission].
abstract: OBJECTIVE
  To validate plasma Neutrophil Gelatinase-Associated Lipocalin (pNGAL) as an early biomarker in intensive care unit (ICU) for acute kidney injury (AKI) in critically ill adult with septic shock.
  
  
  METHODS
  Fifty consecutive patients with septic shock were included in this observational cohort study. AKI was defined if patients met any RIFLE or AKIN criteria. The main objective was to evaluate diagnosis value of pNGAL measured with a point-of-care device at admission (D0), at 24hours (D1) and at 48hours (D2).
  
  
  RESULTS
  Among the 50 patients enrolled, 86% had AKI, 48% had persistent renal AKI and 30% required renal replacement therapy (RRT) during their ICU stay. At D0, pNGAL concentration was significantly higher in patients with AKI compared to patients without AKI (471ng/mL versus 134ng/mL, P<0.001). This level remained significantly higher in the AKI population at D1 and D2 and pNGAL concentration at D0 among AKI patients increased with kidney failure level. At D1, pNGAL was significantly higher for persistent renal AKI rather than transient prerenal (570ng/mL versus 337ng/mL, P=0.027). pNGAL concentration below 348ng/mL at D1 was never seen in patients with RRT.
  
  
  CONCLUSIONS
  Plasma NGAL is a useful, sensitive and early biomarker to predict persistent AKI in septic shock at ICU admission and help to discuss RRT.
authors: Service de réanimation médicale, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France. fabrice.camou@chu-bordeaux.fr
authors: F
authors: F
authors: Camou
authors: S
authors: S
authors: Oger
authors: C
authors: C
authors: Paroissin
authors: E
authors: E
authors: Guilhon
authors: O
authors: O
authors: Guisset
authors: G
authors: G
authors: Mourissoux
authors: H
authors: H
authors: Pouyes
authors: T
authors: T
authors: Lalanne
authors: C
authors: C
authors: Gabinski
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000209:Acute-Phase Proteins / Q000378:metabolism; D000328:Adult; D000368:Aged; D015415:Biomarkers; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D004198:Disease Susceptibility; D004231:Diuresis; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007687:Kidney Tubules, Proximal / Q000378:metabolism; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000378:metabolism; D017582:Renal Replacement Therapy; D012772:Shock, Septic / Q000150:complications*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine; D009638:Norepinephrine