title: Plasma NGAL predicts early acute kidney injury no earlier than s-creatinine or cystatin C in severely burned patients.
abstract: BACKGROUND
  Neutrophil gelatinase-associated lipocalin (NGAL) is a novel biomarker used in acute kidney injury (AKI) diagnostics. Studies on burn patients have highlighted it as a promising biomarker for early detection of AKI. This study was designed to discover whether plasma NGAL is as a biomarker superior to serum creatinine and cystatin C in detecting AKI in severely burned patients.
  
  
  METHODS
  Nineteen subjects were enrolled from March 2013 to September 2014 in the Helsinki Burn Centre. Serum creatinine, cystatin C, and plasma NGAL were collected from the patients at admission and every 12h during the first 48h and thereafter daily until seven days following admission. AKI was defined by acute kidney injury network criteria.
  
  
  RESULTS
  Nine (47%) developed AKI during their intensive care unit stay and two (11%) underwent renal replacement therapy. All biomarkers were significantly higher in the AKI group but serum creatinine- and cystatin C values reacted more rapidly to changes in kidney function than did plasma NGAL. Plasma NGAL tended to rise on average 72h±29h (95% CI) later in patients with early AKI than did serum creatinine. Area-under-the-curve values calculated for each biomarker were 0.92 for serum creatinine, 0.87 for cystatin C, and 0.62 for plasma NGAL predicting AKI by the receiver-operating-characteristic method.
  
  
  CONCLUSIONS
  This study demonstrated serum creatinine and cystatin C as faster and more reliable biomarkers than plasma NGAL in detecting early AKI within one week of injury in patients with severe burns.
authors.affiliation: Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Ilmari
authors.initials: I
authors.lastname: Rakkolainen
authors.affiliation: Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Electronic address: jyrki.vuola@helsinki.fi.
authors.forename: Jyrki
authors.initials: J
authors.lastname: Vuola
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000097:blood*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006801:Humans; D000071068:Lipocalin-2 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D015415:Biomarkers; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D003404:Creatinine
keywords: Acute kidney injury; Burns; Creatinine; Cystatin C; Neutrophil gelatinase-associated lipocalin