NGAL: an emerging tool for predicting severity of AKI is easily detected by a clinical assay

摘要

CitationBennett M, Dent CL, Ma Q, Dastrala S, Grenier F, Workman R, Syed H, Ali S, Barasch J, Devarajan P: Urine NGAL predicts severity of acute kidney injury after cardiac surgery: a prospective study. Clin J Am Soc Nephrol 2008, 3:665-673 [1].BackgroundThe 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). The availability of a standardized clinical platform for NGAL measurements could revolutionize renal diagnostics, especially in intensive care situations.MethodsObjectiveThe first objective of the present study was to determine whether an NGAL immunoassay developed for a standardized clinical platform (ARCHITECT? analyzer, Abbott Diagnostics) correlates with the research-based assay. The second objective was to determine the utility of the standardized NGAL immunoassay as a predictive biomarker of AKI after CPB in a large prospective cohort.DesignProspective cohort studySettingChildren's hospital at a large US academic medical center.Subjects196 children undergoing elective CPB for surgical correction or palliation of congenital heart lesions between January 2004 and June 2006.InterventionNone.OutcomesThe primary outcome variable was the development of AKI, defined as a 50% or greater increase in serum creatinine from baseline. Other outcomes included percent change in serum creatinine, days in AKI, dialysis requirement, length of hospital stay, and mortality.