title: Plasma Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Cardiovascular Events in Patients with Chronic Kidney Disease.
abstract: BACKGROUND
  Our aim was to assess plasma neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of cardiovascular (CV) events in patients with chronic kidney disease (CKD) and no history of CV events.
  
  
  METHODS
  This was a prospective observational cohort study of 252 patients with predialysis CKD. CV events were defined as CV death, acute coronary syndrome, and hospitalization for worsening heart failure, stroke, and aortic dissection.
  
  
  RESULTS
  During a median follow-up period of 63 months, 36 CV events occurred. On Cox stepwise multivariate analysis, plasma NGAL and B-type natriuretic peptide (BNP) were significant predictors of CV events. Kaplan-Meier incidence rates of CV event-free survival at 5 years were 96.6%, 92.9%, 85.9%, and 61.3%, respectively, among quartiles of plasma NGAL (P < 0.0001). The C-index for the receiver-operating characteristic curves for CV events was greater when plasma NGAL was added to an established risk model (0.801, 95% CI 0.717-0.885), compared to the model without plasma NGAL (0.746, 95% CI 0.653-0.840, P = 0.021).
  
  
  CONCLUSIONS
  Elevated plasma NGAL could predict future CV events in CKD patients with no history of CV events and add incremental value to the established risk model.
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Midori
authors.identifier: 0000-0001-8820-9682
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Laboratory of Clinical Medicine, Department of Joint Research, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishii
authors.affiliation: Laboratory of Clinical Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kitagawa
authors.affiliation: Division of Medical Statistics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sugiyama
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Tada
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kanayama
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Koide
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakai
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoakeshi, Aichi 470-1192, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yuzawa
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D000071068:Lipocalin-2 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D000071068:Lipocalin-2