Neutrophil gelatinase-associated lipocalin (NGAL): a promising biomarker for the early diagnosis of acute kidney injury (AKI).

Acute kidney injury (AKI) is a common complication that occurs in a broad spectrum of clinical settings. Cardiac surgery-associated AKI continues to be a well-recognized complication of cardiac surgery with high morbidity and mortality. The lack of early biomarkers has for long prevented timely interventions to mitigate the effects of AKI. Serum creatinine is not a timely marker of AKI, so that it cannot be used to set potentially effective therapies to treat AKI in patients during phases when the injury is still potentially reversible. Neutrophil gelatinase-associated lipocalin (NGAL) has been identified as a promising biomarker for early detection of AKI. Several studies have shown that NGAL levels significantly increase in AKI patients 24 to 48 hours before a detectable increase of serum creatinine. Recent studies also suggest that measurements of urinary NGAL levels in patients at risk for cardiac surgery-associated AKI may facilitate its early diagnosis and allow clinicians to implement therapeutic adjustments that have the potential to reverse renal cellular damage and minimize further kidney injury.

[1]  G. Lippi,et al.  Variation of serum and urinary neutrophil gelatinase associated lipocalin (NGAL) after strenuous physical exercise , 2012, Clinical chemistry and laboratory medicine.

[2]  G. Lippi,et al.  Serum but not urine concentration of neutrophil gelatinase-associated lipocalin is influenced by acute leukocyte variations , 2012, Leukemia & lymphoma.

[3]  G. Lippi,et al.  Evaluation of NGAL Test™, a fully-automated neutrophil gelatinase-associated lipocalin (NGAL) immunoassay on Beckman Coulter AU 5822 , 2012, Clinical chemistry and laboratory medicine.

[4]  C. Ronco,et al.  Article in press-uncorrected proof Review New biomarkers for acute renal injury , 2011 .

[5]  Rinaldo Bellomo,et al.  Novel and conventional serum biomarkers predicting acute kidney injury in adult cardiac surgery—A prospective cohort study* , 2009, Critical care medicine.

[6]  V. Jeevanandam,et al.  Urinary cystatin C as an early biomarker of acute kidney injury following adult cardiothoracic surgery. , 2008, Kidney international.

[7]  Mihwa Kim,et al.  Urinary neutrophil gelatinase-associated lipocalin and acute kidney injury after cardiac surgery. , 2008, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[8]  T. Nickolas,et al.  Sensitivity and Specificity of a Single Emergency Department Measurement of Urinary Neutrophil GelatinaseAssociated Lipocalin for Diagnosing Acute Kidney Injury , 2008, Annals of Internal Medicine.

[9]  F. Grenier,et al.  Urine NGAL predicts severity of acute kidney injury after cardiac surgery: a prospective study. , 2008, Clinical journal of the American Society of Nephrology : CJASN.

[10]  S. Waikar,et al.  Urinary biomarkers in the early diagnosis of acute kidney injury. , 2008, Kidney international.

[11]  Changchun Cao,et al.  Urine Neutrophil Gelatinase-Associated Lipocalin and Interleukin-18 Predict Acute Kidney Injury after Cardiac Surgery , 2008, Renal failure.

[12]  B. Jaber,et al.  Urinary N-acetyl-beta-(D)-glucosaminidase activity and kidney injury molecule-1 level are associated with adverse outcomes in acute renal failure. , 2007, Journal of the American Society of Nephrology : JASN.

[13]  Mihwa Kim,et al.  Association between Increases in Urinary Neutrophil Gelatinase–associated Lipocalin and Acute Renal Dysfunction after Adult Cardiac Surgery , 2006, Anesthesiology.

[14]  C. Edelstein,et al.  Urinary IL-18 is an early predictive biomarker of acute kidney injury after cardiac surgery. , 2006, Kidney international.

[15]  P. Devarajan Update on mechanisms of ischemic acute kidney injury. , 2006, Journal of the American Society of Nephrology : JASN.

[16]  Joseph V Bonventre,et al.  Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. , 2005, Journal of the American Society of Nephrology : JASN.

[17]  Qing Ma,et al.  Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery , 2005, The Lancet.

[18]  A. Kribben,et al.  Early detection of acute renal failure by serum cystatin C. , 2004, Kidney international.

[19]  L. Bachmann,et al.  Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. , 2004, Journal of the American Society of Nephrology : JASN.

[20]  R. Bellomo,et al.  Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group , 2004, Critical care.

[21]  M. Mitsnefes,et al.  Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury. , 2003, Journal of the American Society of Nephrology : JASN.

[22]  R. Kucherlapati,et al.  Differential gene expression following early renal ischemia/reperfusion. , 2003, Kidney international.

[23]  J. Decruyenaere,et al.  Acute renal failure in patients with sepsis in a surgical ICU: predictive factors, incidence, comorbidity, and outcome. , 2003, Journal of the American Society of Nephrology : JASN.