Neutrophil gelatinase-associated lipocalin levels during the first 48 hours of intensive care may indicate upcoming acute kidney injury.
The recognition of acute kidney injury (AKI) as early as possible is important in the intensive care unit. This study proposes that serum and urine levels of neutrophil gelatinase-associated lipocalin (NGAL) may be used for this purpose.



One hundred and seven critically ill adult patients with no previous renal failure were included. NGAL levels were measured during the first 48 hours after admission; NGAL levels were followed for 7 days and classified based on Risk, Injury, Failure, Loss, and End-Stage Renal Failure criteria.



The AKI incidence was 35.5%, and serum NGAL (sNGAL) and urinary NGAL (uNGAL) levels were higher in the AKI group. The area under the receiver operating characteristic curve was 0.76 (P<.001) for sNGAL and 0.75 (P<.001) for uNGAL. Seventy-one percent of AKI cases were observed within 48 hours, with 11 additional cases in the ensuing 7 days. The mean serum creatinine levels in the 11 patients were not different from non-AKI levels (P=.197), but the NGAL values were different, and the area under the receiver operating characteristic curve for sNGAL uNGAL was 1.00 (P=.014) and 0.93 (P=.02), respectively.



Most AKI cases were diagnosed within the first 48 hours after admission, and NGAL was useful for predicting upcoming AKI.
Department of Internal Medicine, Kocaeli University Medical School, University Hospital, Umuttepe Campus, Uctepeler, Kocaeli, Turkey. Electronic address: fatihkamis@hotmail.com.
Fatih
F
Kamis
Department of Internal Medicine, Kocaeli University Medical School, University Hospital, Umuttepe Campus, Uctepeler, Kocaeli, Turkey. Electronic address: itiryegenaga@hotmail.com.
Itir
I
Yegenaga
Department of Biochemistry, Kocaeli University Medical School, University Hospital, Umuttepe Campus, Uctepeler, Kocaeli, Turkey. Electronic address: mertmusul@hotmail.com.
Mert
M
Musul
Department of Biostatistics, University Hospital, Umuttepe Campus-Uctepeler, Kocaeli University Medical School, Kocaeli, Turkey. Electronic address: canandoruk@hotmail.com.
Canan
C
Baydemir
Department of Internal Medicine, Kocaeli University Medical School, University Hospital, Umuttepe Campus, Uctepeler, Kocaeli, Turkey.
Sibel
S
Bek
Department of Internal Medicine, Kocaeli University Medical School, University Hospital, Umuttepe Campus, Uctepeler, Kocaeli, Turkey.
Betül
B
Kalender
Department of Intensive Care, University Hospital, Umuttepe Campus-Uctepeler, Kocaeli University Medical School, Kocaeli, Turkey. Electronic address: baykaranur@yahoo.com.
Nur
N
Baykara
D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis / Q000652:urine; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003422:Critical Care; D016638:Critical Illness; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D000071068:Lipocalin-2 / Q000097:blood* / Q000652:urine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2
Acute kidney injury; Biomarker; Critically ill; NGAL