Importance of neutrophil gelatinase-associated lipocalin in differential diagnosis of acute and chronic renal failure.
BACKGROUND
Neutrophil Gelatinase-associated Lipocalin (NGAL) protein is easily detected in the blood and urine soon after acute renal injury. NGAL gains features of an early, sensitive and noninvasive biomarker for acute renal injury. Recent evidences suggest that its expression is also increased in CRF reflecting the severity of disease.


OBJECTIVE
In the present study, we aimed to investigate whether blood NGAL level plays a role in the differential diagnosis of acute and chronic renal failure.


METHODS
This was a prospective case-control study. Fifty patients presented to emergency department with acute renal failure (ARF), 30 with chronic renal failure (CRF) and 20 healthy individuals as control group were included in this study. Blood pH, HCO3(-), BUN, creatinine and potassium values were evaluated in all patients. Blood NGAL values were evaluated in all groups. BUN, serum creatinine and NGAL values were statistically compared between patients and controls.


RESULTS
Median NGAL levels in patients was 304.50 (29), and 60 (0) in control, which was statistically significant between the two groups (Z = -6.477, P < 0.001). The median NGAL values were 261.50 ± 291 in ARF group and 428.50 ± 294 in CRF group. There was a significant difference in NGAL level between ARF and CRF groups (Z = -2.52, P = 0.012). Median BUN values were 153.46 ± 82.47 in ARF group and 169.40 ± 93.94 in CRF group. There was no significant difference in BUN value between ARF and CRF groups (P > 0.05). Median creatinine values were 2.84 ± 2.95 in ARF group and 4.78 ± 4.32 in CRF group. In serum creatinine values, a significant difference was found between ARF and CRF groups (P < 0.05).


CONCLUSIONS
Serum NGAL levels of ARF and CRF patients were significantly higher than healthy individuals. In addition, NGAL values of patients with CRF were significantly higher than those of ARF. Serum NGAL values can be used to detect renal injury and differentiate ARF and CRF.
Department of Emergency Medicine, Diskapi Training and Research Hospital, Ankara, Turkey.
Seda
S
Ozkan
Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Polat
P
Durukan
Department of Emergency Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey.
Cemil
C
Kavalci
Department of Emergency Medicine, Isparta State Hospital, Isparta, Turkey.
Ali
A
Duman
Department of Emergency Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey.
Mustafa Burak
MB
Sayhan
Emergency Department, Yozgat State Hospital, Yozgat, Turkey.
Omer
O
Salt
Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Afsin
A
Ipekci
Acute; Chronic; NGAL Protein; Renal Failure