title: Plasma neutrophil gelatinase-associated lipocalin as early biomarker for acute kidney injury in burn patients.
abstract: This study evaluated whether measurements of plasma neutrophil gelatinase-associated lipocalin (NGAL) can predict acute kidney injury (AKI) in adult burn patients, and assessed the use of this biomarker in risk stratification. We performed a prospective observational study of consecutive patients with major burns admitted to the burn center within 12 hours of injury. Samples for plasma NGAL assay were obtained three times (at admission, day 3, and day 7). The main outcome measures were occurrence of AKI based on Risk-Injury-Failure classification and mortality. A total 45 patients with burns injury were enrolled. There was a high prevalence (11 of 45, 24.4%) of AKI in burn patients. All patients with AKI developed AKI after hospital day 8. Multivariate logistic regression analysis demonstrated that burn size and abbreviated burn severity index were independent risk factors of AKI. Patients who developed AKI had significantly higher admission plasma NGAL levels, hospital day 3 NGAL levels, and hospital day 7 NGAL levels. Especially, hospital day 7 NGAL levels strongly correlated with AKI. For concentration in plasma NGAL at hospital day 7, the area under the receiver operating characteristic curve was 0.903, sensitivity was 87%, and specificity was 91% for a cutoff value of 125 ng/ml. The mean plasma NGAL at hospital day 7 of patients who died was significantly higher than that of patients who did not (485 ng/ml vs 111 ng/ml, P = .001). Plasma NGAL levels are early predictive biomarkers for AKI and its clinical outcomes after burn injury.
authors.affiliation: From the *Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea; and †Department of Emergency Medicine, Bestian Medical Center, Seoul, Korea.
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Hong
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Sang O
authors.initials: SO
authors.lastname: Park
authors.forename: Kwang Je
authors.initials: KJ
authors.lastname: Baek
authors.forename: Kyeong Ryong
authors.initials: KR
authors.lastname: Lee
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D000209:Acute-Phase Proteins; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000097:blood* / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood*; D056910:Republic of Korea / Q000453:epidemiology; D012151:Resuscitation / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins