title: Neutrophil gelatinase-associated lipocalin and liver-type fatty acid-binding protein as biomarkers for acute kidney injury after organ transplantation.
abstract: OBJECTIVE
  Neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding protein (L-FABP) are promising early biomarkers for acute kidney injury (AKI). In organ transplant recipients, AKI predictability based on NGAL and L-FABP remains to be elucidated. Furthermore, the association between serial NGAL and L-FABP measurements and AKI outcome is unknown. Therefore, we conducted a study to evaluate the ability of NGAL and L-FABP to predict AKI after organ transplantation and investigate the association between NGAL, L-FABP and AKI outcome.
  
  
  METHODS
  Twenty-five organ transplant recipients admitted to the intensive care unit (ICU) immediately after transplant surgery were studied prospectively. Plasma NGAL (P-NGAL), urinary NGAL (U-NGAL) and L-FABP were measured from ICU admission to ICU discharge. U-NGAL and L-FABP were corrected for dilution/concentration by calculating U-NGAL/urine creatinine ratios (U-NGAL/Cr) and L-FABP/urine creatinine ratios (L-FABP/Cr). AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria.
  
  
  RESULTS
  AKI occurred in 11 patients. P-NGAL, U-NGAL/Cr and L-FABP/Cr upon ICU admission were unrelated to AKI development (p = 0.24, 0.22, and 0.53, respectively). There were no differences in P-NGAL, U-NGAL/Cr, and L-FABP/Cr levels from day 1 to day 6 between patients who did not recover from AKI and patients who recovered from AKI (p = 0.82, 0.26, and 0.61, respectively).
  
  
  CONCLUSIONS
  Our findings suggest that NGAL and L-FABP upon ICU admission are not predictive of AKI and serial NGAL and L-FABP measurements may be ineffective for monitoring the status and treatment of post-transplantation AKI.
authors.affiliation: Intensive Care Unit, Osaka University Hospital, 2-15, Yamadaoka, Suita, Osaka, 565-0871, Japan, iguchi@hp-icu.med.osaka-u.ac.jp.
authors.forename: Naoya
authors.initials: N
authors.lastname: Iguchi
authors.forename: Akinori
authors.initials: A
authors.lastname: Uchiyama
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ueta
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujino
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000209:etiology*; D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood* / Q000652:urine*; D003404:Creatinine / Q000652:urine; D050556:Fatty Acid-Binding Proteins / Q000097:blood* / Q000652:urine*; D005260:Female; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000652:urine*; D016896:Treatment Outcome
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine