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The nature and disc...
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Glassford, Neil J.
(author)
The nature and discriminatory value of urinary neutrophil gelatinase-associated lipocalin in critically ill patients at risk of acute kidney injury
- Article/chapterEnglish2013
Publisher, publication year, extent ...
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2013-08-06
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Springer Science and Business Media LLC,2013
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-209157
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-209157URI
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https://doi.org/10.1007/s00134-013-3040-7DOI
Supplementary language notes
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Language:English
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Summary in:English
Part of subdatabase
Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Different molecular forms of urinary neutrophil gelatinase-associated lipocalin (NGAL) have recently been discovered. We aimed to explore the nature, source and discriminatory value of urinary NGAL in intensive care unit (ICU) patients. We simultaneously measured plasma NGAL (pNGAL), urinary NGAL (uNGAL), and estimated monomeric and homodimeric uNGAL contribution using Western blotting-validated enzyme-linked immunosorbent assays [uNGAL(E1) and uNGAL(E2)] and their calculated ratio in 102 patients with the systemic inflammatory response syndrome and oliguria, and/or a creatinine rise of > 25 mu mol/L. Bland-Altman analysis demonstrated that, despite correlating well (r = 0.988), uNGAL and uNGAL(E1) were clinically distinct, lacking both accuracy and precision (bias: 266.23; 95 % CI 82.03-450.44 ng/mg creatinine; limits of agreement: -1,573.86 to 2,106.32 ng/mg creatinine). At best, urinary forms of NGAL are fair (area under the receiver operating characteristic [AUROC] a parts per thousand currency sign0.799) predictors of renal or patient outcome; most perform significantly worse. The 44 patients with a primarily monomeric source of uNGAL had higher pNGAL (118.5 ng/ml vs. 72.5 ng/ml; p < 0.001), remaining significant following Bonferroni correction. uNGAL is not a useful predictor of outcome in this ICU population. uNGAL patterns may predict distinct clinical phenotypes. The nature and source of uNGAL are complex and challenge the utility of NGAL as a uniform biomarker.
Subject headings and genre
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Acute kidney injury
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Oliguria
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Critical illness
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Intensive care
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Biomarker
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Systemic inflammatory response syndrome
Added entries (persons, corporate bodies, meetings, titles ...)
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Schneider, Antoine G.
(author)
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Xu, ShengyuanUppsala universitet,Biokemisk struktur och funktion(Swepub:uu)shengyuanxu
(author)
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Eastwood, Glenn M.
(author)
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Young, Helen
(author)
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Peck, Leah
(author)
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Venge, PerUppsala universitet,Biokemisk struktur och funktion(Swepub:uu)pervenge
(author)
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Bellomo, Rinaldo
(author)
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Uppsala universitetBiokemisk struktur och funktion
(creator_code:org_t)
Related titles
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In:Intensive Care Medicine: Springer Science and Business Media LLC39:10, s. 1714-17240342-46421432-1238
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