title: Urinary neutrophil gelatinase-associated lipocalin as an early predictor of disease severity and mortality in acute pancreatitis.
abstract: OBJECTIVE
  In reference to our earlier publication, laboratory tests that reflect severe intravascular volume depletion can be used for predicting the severity of acute pancreatitis (AP). The aim of the study was to assess whether urinary level of neutrophil gelatinase-associated lipocalin (NGAL) could represent a useful marker of AP severity.
  
  
  METHODS
  We observed a cohort of 104 prospectively enrolled patients. The patients were classified into 3 groups: mild AP, moderately severe AP, and severe AP. Urine samples were collected on admission (NGAL-as) and during the first 24 hours (NGAL-first day) for examination of urinary level of NGAL concentrations from the first day.
  
  
  RESULTS
  Acute pancreatitis was considered severe in 16 (15%) patients, moderately severe in 25 (24%) patients, and mild in 63 (61%) patients.There were statistically significant trends for an increase in severity (P = 0.04, P = 0.003) and mortality (P < 0.031, P = 0.01) with raising NGAL-as and NGAL-first day concentrations, respectively. The areas under the curve for severity predicted by NGAL-as and NGAL-first day were 0.75 and 0.93, respectively. The areas under the curve for mortality prediction by NGAL-as and NGAL-first day were 0.980 and 0.92, respectively.
  
  
  CONCLUSIONS
  The urinary level of NGAL is a promising new diagnostic and prognostic factor for severe AP in an early stage of the disease.
authors.affiliation: From the *Department of Gastroenterology, Central Clinical Hospital of the Ministry of Interior, Warsaw; †Department of Nephrology and Transplantation, Medical University of Bialystok, Bialystok; ‡Department of Internal Medicine and Nephrology, Central Clinical Hospital of the Ministry of Interior, Warsaw; and §Faculty of Health Sciences, Uniwersytet Jana Kochanowskiego w Kielcach, Kielce, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Lipinski
authors.forename: Alicja
authors.initials: A
authors.lastname: Rydzewska-Rosolowska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Rydzewski
authors.forename: Grazyna
authors.initials: G
authors.lastname: Rydzewska
mesh_terms: D000208:Acute Disease; D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D005260:Female; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000401:mortality* / Q000652:urine*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012372:ROC Curve; D012720:Severity of Illness Index; D013997:Time Factors; D015854:Up-Regulation; D016482:Urinalysis; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins