title: Serum neutrophil gelatinase-associated lipocalin and recovery of kidney graft function after transplantation.
abstract: BACKGROUND
  Neutrophil gelatinase-associated lipocalin (NGAL) is a marker for acute kidney injury. We studied whether serum NGAL predicts delayed graft function (DGF) and recovery of kidney function after transplantation.
  
  
  METHODS
  Serum NGAL was analyzed using commercial ELISA and point-of-care (POC) (Triage®, Biosite) methods. Serum samples were collected from 176 consecutive, deceased-donor kidney recipients just before transplant surgery and on day 1 and 14 after transplantation. The first 132 samples were analyzed with both methods and the remaining samples with the POC method.
  
  
  RESULTS
  The correlation between the ELISA and POC methods was 0.89, p < 0.0001 and hence the POC method was used for the remaining analyses. DGF was seen in 66/176 patients. Day 1 sNGAL was significantly higher in DGF (588 ng/ml, SD 189.6) compared to early graft function (355 ng/ml, SD 166.2, p < 0.0001) and this difference persisted on day 14. Day 1 sNGAL predicted DGF with an area under the curve (AUC) of 0.853 (CI 0.792-0.914, p < 0.0001). At the optimal cutoff level of 423 ng/ml the sensitivity was 87% and the specificity 77%. In a multivariate analysis, day 1 sNGAL emerged as an independent predictor of DGF. The sNGAL also predicted DGF lasting longer than 14 days with an AUC of 0.825 (CI 0.751-0.899, p < 0.0001). At the optimal cutoff level of 486 ng/ml, the sensitivity was 80% and specificity 75%.
  
  
  CONCLUSIONS
  Serum NGAL predicts clinically significant DGF and is useful in the care of kidney transplant recipients.
authors: Department of Medicine, Division of Nephrology, Helsinki University Hospital, Haartmaninkatu 4, PL 372, Helsinki 00029, HUS, Finland. maria.hollmen@helsinki.fi.
authors: Maria E
authors: ME
authors: Hollmen
authors: Lauri E
authors: LE
authors: Kyllönen
authors: Jussi
authors: J
authors: Merenmies
authors: Kaija T
authors: KT
authors: Salmela
mesh_terms: D000209:Acute-Phase Proteins; D000368:Aged; D015415:Biomarkers / Q000097:blood; D051799:Delayed Graft Function / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000639:trends*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000097:blood*; D014019:Tissue Donors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins