title: Urinary Neutrophil Gelatinase-associated Lipocalin as a Marker for Identification of Acute Kidney Injury and Recovery in Dogs with Gentamicin-induced Nephrotoxicity.
abstract: BACKGROUND
  Acute kidney injury (AKI) is associated with high mortality rates in dogs, which may be a consequence of late recognition using traditional diagnostic tests. Neutrophil gelatinase-associated lipocalin (NGAL) is a protein-induced during kidney injury that may identify AKI earlier than traditional tests.
  
  
  OBJECTIVE
  To evaluate urinary NGAL (uNGAL) and uNGAL-to-urinary creatinine ratio (UNCR) as early markers of kidney injury and recovery in an AKI model in dogs. It was hypothesized that these markers would document AKI earlier than serum creatinine concentration.
  
  
  METHODS
  Five purpose-bred dogs.
  
  
  METHODS
  Prospective study. Acute kidney injury, defined as a > 50% increase in serum creatinine concentration above baseline, was induced in dogs by gentamicin administration (8-10 mg/kg SC q8h). Blood and urine collected for biochemical analyses and uNGAL and urinary creatinine concentrations, respectively, during AKI induction and recovery.
  
  
  RESULTS
  Acute kidney injury was diagnosed significantly earlier based on a 7-fold increase in UNCR compared to a > 50% increase in serum creatinine concentration (day 8; range, 2-10 mg/dl vs day 16; range, 14-19 mg/dl; P = .009). During recovery, the initial decrease in UNCR preceded the decrease in serum creatinine concentration by a median of 2 days. The uNGAL changes paralleled UNCR changes, but the increase in uNGAL was triphasic; the initial peak occurred earlier than UNCR (median, day 11 versus median, day 19).
  
  
  CONCLUSIONS
  The UNCR was early marker of gentamicin-induced AKI and its decrease documented onset of renal recovery. Additional studies are needed to validate this marker in dogs with naturally occurring renal injury.
authors.affiliation: Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA.
authors.forename: C A
authors.initials: CA
authors.lastname: Palm
authors.affiliation: The Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Segev
authors.affiliation: Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA.
authors.forename: L D
authors.initials: LD
authors.lastname: Cowgill
authors.affiliation: AbbVie, North Chicago, IL.
authors.forename: B E
authors.initials: BE
authors.lastname: LeRoy
authors.affiliation: AbbVie, North Chicago, IL.
authors.forename: K L
authors.initials: KL
authors.lastname: Kowalkowski
authors.affiliation: Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA.
authors.forename: K
authors.initials: K
authors.lastname: Kanakubo
authors.affiliation: Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA.
authors.forename: J L
authors.initials: JL
authors.lastname: Westropp
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000652:urine / Q000662:veterinary*; D000209:Acute-Phase Proteins / Q000235:genetics / Q000378:metabolism* / Q000652:urine; D000818:Animals; D003404:Creatinine / Q000652:urine; D004283:Dog Diseases / Q000097:blood / Q000139:chemically induced* / Q000378:metabolism; D004285:Dogs; D054834:Lipocalins / Q000235:genetics / Q000378:metabolism* / Q000652:urine; D011518:Proto-Oncogene Proteins / Q000235:genetics / Q000378:metabolism* / Q000652:urine
chemical_list: D000209:Acute-Phase Proteins; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; C000589991:neutrophil gelatinase-associated lipocalin protein, dog; D003404:Creatinine
keywords: Acute kidney injury; Biomarker; Neutrophil gelatinase-associated lipocalin; uNGAL to urinary creatinine ratio