title: Predictive value of plasma neutrophil gelatinase-associated lipocalin for acute renal failure in patients with severe sepsis.
abstract: BACKGROUND
  Predicting acute renal failure in patients with severe sepsis is important, because patients may need renal replacement therapy (RRT). Neutrophil gelatinase-associated lipocalin (NGAL) has been evaluated for its ability to detect and predict acute kidney injury (AKI) in critically ill patients. This study aimed to assess the predictive value of plasma NGAL for acute renal failure in adult severely septic patients.
  
  
  METHODS
  Thirty healthy adults and 85 adult patients admitted to the medical intensive care unit (ICU) were enrolled. Serum creatinine, plasma NGAL, and interleukin (IL)-6, IL-10, and IL-17 levels were evaluated. AKI was classified as Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE).
  
  
  RESULTS
  RIFLE-Failure (RIFLE-F) developed in 30 of 76 (39.5%) patients with severe sepsis without chronic kidney disease within 7 days after ICU admission. Serum creatinine, plasma NGAL, IL-6, and IL-10 could predict RIFLE-F within 7 days after ICU admission. The discriminatory power of plasma NGAL was not significant for predicting hospital mortality. The area under the receiver operating characteristic curve of plasma NGAL was not higher than that of serum creatinine in predicting RIFLE-F within 7 days.
  
  
  CONCLUSIONS
  Plasma NGAL is a useful tool for predicting acute renal failure in adult patients with severe sepsis. Serum creatinine has a similar ability to detect RIFLE-F occurrence.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Huang
authors.affiliation: Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
authors.forename: Chi-Chung
authors.initials: CC
authors.lastname: Shih
authors.affiliation: Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
authors.forename: Kong
authors.initials: K
authors.lastname: Chung
authors.affiliation: Department of Thoracic Medicine, Keelung Chang Gung Memorial Hospital, Linkou, Taiwan, ROC; Chang Gung University, College of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Kao
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC; Chang Gung University, College of Medicine, Taoyuan, Taiwan, ROC. Electronic address: whanpyng@cgmh.org.tw.
authors.forename: Huang-Pin
authors.initials: HP
authors.lastname: Wu
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D000328:Adult; D000368:Aged; D015415:Biomarkers; D003404:Creatinine / Q000097:blood; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D000071068:Lipocalin-2 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications*
chemical_list: D015415:Biomarkers; D016207:Cytokines; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D003404:Creatinine
keywords: acute kidney injury; biomarkers; neutrophil gelatinase-associated lipocalin; renal replacement therapy; severe sepsis