Urine NGAL predicts severity of acute kidney injury after cardiac surgery: a prospective study.
BACKGROUND AND OBJECTIVES The authors have previously shown that urine neutrophil gelatinase-associated lipocalin (NGAL), measured by a research ELISA, is an early predictive biomarker of acute kidney injury (AKI) after cardiopulmonary bypass (CPB). In this study, whether an NGAL immunoassay developed for a standardized clinical platform (ARCHITECT analyzer, Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL) can predict AKI after CPB was tested. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In a pilot study with 136 urine samples (NGAL range, 0.3 to 815 ng/ml) and 6 calibration standards (NGAL range, 0 to 1000 ng/ml), NGAL measurements by research ELISA and by the ARCHITECT assay were highly correlated (r = 0.99). In a subsequent study, 196 children undergoing CPB were prospectively enrolled and serial urine NGAL measurements obtained by ARCHITECT assay. The primary outcome was AKI, defined as a > or = 50% increase in serum creatinine. RESULTS AKI developed in 99 patients (51%), but the diagnosis using serum creatinine was delayed by 2 to 3 d after CPB. In contrast, mean urine NGAL levels increased 15-fold within 2 h and by 25-fold at 4 and 6 h after CPB. For the 2-h urine NGAL measurement, the area under the curve was 0.95, sensitivity was 0.82, and the specificity was 0.90 for prediction of AKI using a cutoff value of 100 ng/ml. The 2-h urine NGAL levels correlated with severity and duration of AKI, length of stay, dialysis requirement, and death. CONCLUSIONS Accurate measurements of urine NGAL are obtained using the ARCHITECT platform. Urine NGAL is an early predictive biomarker of AKI severity after CPB.
Urine NGAL predicts severity of acute kidney injury after cardiac surgery: a prospective study.
BACKGROUND AND OBJECTIVES The authors have previously shown that urine neutrophil gelatinase-associated lipocalin (NGAL), measured by a research ELISA, is an early predictive biomarker of acute kidney injury (AKI) after cardiopulmonary bypass (CPB). In this study, whether an NGAL immunoassay developed for a standardized clinical platform (ARCHITECT analyzer, Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL) can predict AKI after CPB was tested. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In a pilot study with 136 urine samples (NGAL range, 0.3 to 815 ng/ml) and 6 calibration standards (NGAL range, 0 to 1000 ng/ml), NGAL measurements by research ELISA and by the ARCHITECT assay were highly correlated (r = 0.99). In a subsequent study, 196 children undergoing CPB were prospectively enrolled and serial urine NGAL measurements obtained by ARCHITECT assay. The primary outcome was AKI, defined as a > or = 50% increase in serum creatinine. RESULTS AKI developed in 99 patients (51%), but the diagnosis using serum creatinine was delayed by 2 to 3 d after CPB. In contrast, mean urine NGAL levels increased 15-fold within 2 h and by 25-fold at 4 and 6 h after CPB. For the 2-h urine NGAL measurement, the area under the curve was 0.95, sensitivity was 0.82, and the specificity was 0.90 for prediction of AKI using a cutoff value of 100 ng/ml. The 2-h urine NGAL levels correlated with severity and duration of AKI, length of stay, dialysis requirement, and death. CONCLUSIONS Accurate measurements of urine NGAL are obtained using the ARCHITECT platform. Urine NGAL is an early predictive biomarker of AKI severity after CPB.
time series recurrent neural network metric space health care discrete wavelet transform sample size confidence interval discrete fourier transform systematic review dimensionality reduction internet service euclidean distance traffic engineering internet service provider web search engine amino acid internet traffic intensive care unit time warping similarity search background and objective x-ray computed tomography heart failure traffic classification large time body mass index early diagnosi evaluation procedure dimensionality reduction technique growth factor internet routing kidney disease signal transduction symmetric encryption chronic kidney disease sequence database chronic kidney time series database today internet scaling behavior internet backbone searchable symmetric encryption cardiac surgery series database internet traffic classification searchable symmetric oxidative stres publication bia cell surface efficient similarity external validation large time series efficient similarity search time warping distance glomerular filtration rate effective sample size hospital admission fast similarity fast similarity search plasma membrane acute kidney injury acute kidney kidney injury internet traffic engineering approximate similarity search search in large dynamic searchable area under curve kidney transplantation today internet traffic sse scheme dynamic searchable symmetric radical polymerization abbott laboratory traffic classification technique renal replacement therapy cell physiology ckd patient wide-area internet internet traffic measurement improved definition fibroblast growth factor chain transfer biological marker fibroblast growth genetic heterogeneity lipid raft excretory function cns disorder entity name part qualifier - adopted cessation of life standards characteristic complement system protein one thousand hypertensive disease limited stage (cancer stage) tissue membrane glutathione s-transferase adverse reaction to drug diameter (qualifier value) congenital abnormality kidney failure, chronic renal insufficiency creatinine measurement, serum (procedure) forecast of outcome stage level 1 microgram per liter milliliter per minute diagnosis, clinical vesicle (morphologic abnormality) lipid metabolism disorder transplanted tissue membrane protein traffic stage level 3 cfh gene hemolytic-uremic syndrome kidney failure, acute blighia sapida creatinine clearance measurement cystatin c (substance) stage level 5