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Med Intensiva. 2014 Apr;38(3):146-53. doi: 10.1016/j.medin.2013.03.014. Epub 2013 Jul 2.

[Analysis of neutrophil gelatinase-associated lipocalin in the critical patient].

[Article in Spanish]

Author information

1
Servicio de Medicina Intensiva, Bioquímica, Cirugía y Epidemiología, Hospital Universitari Germans Trias i Pujol, Badalona, España. Electronic address: claramarti@yahoo.com.
2
Servicio de Medicina Intensiva, Bioquímica, Cirugía y Epidemiología, Hospital Universitari Germans Trias i Pujol, Badalona, España.
3
Servicio de Oncología Radioterápica, Medicina Preventiva y Salud Pública, Complejo Asistencial Universitario de Salamanca, Salamanca, España.

Abstract

OBJECTIVE:

To determine if NGAL value exceeding 150 ng/mL is a good diagnostic test for acute renal failure in critically ill patients.

DESIGN:

Prospective, observational cohort.

SETTING:

Intensive Care Unit and Cardiac Surgery Intensive Care Service at Hospital Germans Trias I Pujol.

PARTICIPANTS:

Patients admitted to the Intensive Care department the Designated days in the studio.

INTERVENTIONS:

Analysis of serum creatinine blood given from 7 days prior to the start of the study, and daily during 4 weeks and by determination of NGAL urine test in frozen sample, analyzer ARCHITECT (Abbott Diagnostics) determined by immunoassay the day baseline and 2 times a week for 4 weeks, analysis of the stay and mortality.

RESULTS:

A total of 529 NGAL samples were obtained from 46 patients. 37% of patients had a value of NGAL>150 ng/mL. The Sensivity of the test to diagnose acute renal failure was 69%, Specifity was 75,7%. However, the Positive Predictive Test Value was 53%, which means that 47% of patients with high NGAL did not develop AKI. A NGAL >150 mg/dL was associated with a significantly higher SOFA and a longer stay in the ICU. The mortality of patients with elevated NGAL was 58.8%.

CONCLUSIONS:

A NGAL>150 ng/mL does not seem to be an excellent test for AKI in critically ill patients but is associated with a worse prognosis.

KEYWORDS:

Acute renal failure; Critical illness; Fracaso renal agudo; Lipocalina asociada a la gelatinasa de neutrófilos; NGAL; Neutrophil gelatinase-associated lipocalin protein; Paciente crítico

PMID:
23827694
DOI:
10.1016/j.medin.2013.03.014
[Indexed for MEDLINE]
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