Accuracy of plasma neutrophil gelatinase-associated lipocalin in the early diagnosis of contrast-induced acute kidney injury in critical illness
Purpose Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI). We evaluated the diagnostic and prognostic accuracies of plasma NGAL (pNGAL) for contrast-induced AKI (CI-AKI) in critically ill patients. Methods In a prospective observational study in two adult intensive care units in a university hospital, 100 consecutive critically ill patients with stable serum creatinine concentrations up to 48 h before contrast medium (CM) injection were enrolled. Serial blood sampling for pNGAL analysis was performed at enrolment, 2, 6, and 24 h after CM injection. The primary outcome was CI-AKI, defined by AKIN criteria, within the first 72 h following CM injection. Secondary outcomes were the need for renal replacement therapy (RRT) and mortality. Results Of the 98 patients analyzed, 30 developed CI-AKI. The pNGAL levels did not differ in patients with or without CI-AKI, and were higher in septic patients compared to nonseptic patients, and in patients with AKI preceding CM injection. The discriminative value of pNGAL to predict CI-AKI and mortality was poor; although, it did predict the need for RRT requirement after CM injection (area under receiver-operating characteristic curve, 0.85, 0.80, 0.83 and 0.86 at H0, H2, H6 and H24, respectively). Conclusion CI-AKI was common in critically ill patients. pNGAL levels were higher in patients with sepsis or previous AKI, but did not help to diagnose CI-AKI any earlier than serum creatinine after CM injection. However, pNGAL could be of interest to detect patients at risk of subsequent RRT requirement..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2013 |
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| Erschienen: |
2013 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
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| Enthalten in: |
Intensive care medicine - 39(2013), 5 vom: 30. Jan., Seite 857-865 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Valette, Xavier [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Acute kidney injury |
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| Anmerkungen: |
© Springer-Verlag Berlin Heidelberg and ESICM 2013 |
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| doi: |
10.1007/s00134-013-2826-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2024504795 |
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| 245 | 1 | 0 | |a Accuracy of plasma neutrophil gelatinase-associated lipocalin in the early diagnosis of contrast-induced acute kidney injury in critical illness |
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| 520 | |a Purpose Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI). We evaluated the diagnostic and prognostic accuracies of plasma NGAL (pNGAL) for contrast-induced AKI (CI-AKI) in critically ill patients. Methods In a prospective observational study in two adult intensive care units in a university hospital, 100 consecutive critically ill patients with stable serum creatinine concentrations up to 48 h before contrast medium (CM) injection were enrolled. Serial blood sampling for pNGAL analysis was performed at enrolment, 2, 6, and 24 h after CM injection. The primary outcome was CI-AKI, defined by AKIN criteria, within the first 72 h following CM injection. Secondary outcomes were the need for renal replacement therapy (RRT) and mortality. Results Of the 98 patients analyzed, 30 developed CI-AKI. The pNGAL levels did not differ in patients with or without CI-AKI, and were higher in septic patients compared to nonseptic patients, and in patients with AKI preceding CM injection. The discriminative value of pNGAL to predict CI-AKI and mortality was poor; although, it did predict the need for RRT requirement after CM injection (area under receiver-operating characteristic curve, 0.85, 0.80, 0.83 and 0.86 at H0, H2, H6 and H24, respectively). Conclusion CI-AKI was common in critically ill patients. pNGAL levels were higher in patients with sepsis or previous AKI, but did not help to diagnose CI-AKI any earlier than serum creatinine after CM injection. However, pNGAL could be of interest to detect patients at risk of subsequent RRT requirement. | ||
| 650 | 4 | |a Acute kidney injury | |
| 650 | 4 | |a Contrast medium | |
| 650 | 4 | |a Neutrophil gelatinase-associated lipocalin (NGAL) | |
| 650 | 4 | |a Biomarker | |
| 650 | 4 | |a Diagnostic accuracy | |
| 650 | 4 | |a Intensive care medicine | |
| 700 | 1 | |a Savary, Benoit |4 aut | |
| 700 | 1 | |a Nowoczyn, Marie |4 aut | |
| 700 | 1 | |a Daubin, Cédric |4 aut | |
| 700 | 1 | |a Pottier, Véronique |4 aut | |
| 700 | 1 | |a Terzi, Nicolas |4 aut | |
| 700 | 1 | |a Seguin, Amélie |4 aut | |
| 700 | 1 | |a Fradin, Sabine |4 aut | |
| 700 | 1 | |a Charbonneau, Pierre |4 aut | |
| 700 | 1 | |a Hanouz, Jean-Luc |4 aut | |
| 700 | 1 | |a du Cheyron, Damien |4 aut | |
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