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Increased urinary neutrophil gelatinase associated lipocalin in urinary tract infections and leukocyturia

An-Sofie Decavele UGent, Lien Dhondt, Marc De Buyzere and Joris Delanghe UGent (2011) CLINICAL CHEMISTRY AND LABORATORY MEDICINE. 49(6). p.999-1003
abstract
Background: Neutrophil gelatinase associated lipocalin (NGAL) is a protein present in neutrophils. NGAL is a promising biomarker for acute kidney injury. In urinary tract infections, urinary neutrophils can be a potential source of urinary NGAL. We investigated the effects of urinary tract infection and urinary neutrophil counts on urinary NGAL values. Methods: NGAL was assayed using an immunoassay (ARCHITECT). Urine flowcytometry was performed with the UF-1000i (Sysmex). Results: A correlation between the urinary white blood cell (WBC) count and NGAL concentrations was observed: log(Y) (NGAL, mu g/L) = 1.284 + 0.439 log(X) (urinary WBC, 10(9) cells/L); r = 0.518. Similarly, the bacterial count correlated weakly with NGAL: log(Y) (NGAL, mu g/L) = 1.796 + 0.124 log(X) (bacterial count, 10(9) cells/L); r = 0.243. Albuminuria correlated moderately with NGAL values: log(Y) (NGAL, mu g/L) = 1.557 + 0.339 log(X) (albuminuria, mg/L); r = 0.368; alpha(1)-microglobulin (a1M) correlated weakly with NGAL: log(Y) (NGAL, mu g/L) = 1.631 + 0.360 log(X) (a1M, mg/L); r = 0.381. Conclusions: Leukocyte contributions to urinary NGAL concentrations can be important. In leukocyturia or tubular damage (e. g., intensive care patients), using a fixed cut-off value for interpreting urinary NGAL data can lead to false positive results. Therefore, we suggest a mathematical correction in cases with pyuria (> 100 x 1(0)9 cells/L) and urinary NGAL concentration > 100 mu g/L: corrected NGAL (mu g/L) = NGAL-0.12 (urinary WBC, 10(9) cells/L).
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
ACUTE KIDNEY INJURY, BIOMARKER, PROTEINS, PATHOLOGY, NEPHROPATHY, NGAL, urinary tract infection, neutrophil gelatinase associated lipocalin (NGAL), leukocytes, alpha(1)-microglobulin, albuminuria, acute kidney injury, CHILDREN, IRON
journal title
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
Clin. Chem. Lab. Med.
volume
49
issue
6
pages
999 - 1003
Web of Science type
Article
Web of Science id
000291429500010
JCR category
MEDICAL LABORATORY TECHNOLOGY
JCR impact factor
2.15 (2011)
JCR rank
10/32 (2011)
JCR quartile
2 (2011)
ISSN
1434-6621
DOI
10.1515/CCLM.2011.156
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1954976
handle
http://hdl.handle.net/1854/LU-1954976
date created
2011-11-28 15:11:58
date last changed
2016-12-19 15:42:18
@article{1954976,
  abstract     = {Background: Neutrophil gelatinase associated lipocalin (NGAL) is a protein present in neutrophils. NGAL is a promising biomarker for acute kidney injury. In urinary tract infections, urinary neutrophils can be a potential source of urinary NGAL. We investigated the effects of urinary tract infection and urinary neutrophil counts on urinary NGAL values. 
Methods: NGAL was assayed using an immunoassay (ARCHITECT). Urine flowcytometry was performed with the UF-1000i (Sysmex). 
Results: A correlation between the urinary white blood cell (WBC) count and NGAL concentrations was observed: log(Y) (NGAL, mu g/L) = 1.284 + 0.439 log(X) (urinary WBC, 10(9) cells/L); r = 0.518. Similarly, the bacterial count correlated weakly with NGAL: log(Y) (NGAL, mu g/L) = 1.796 + 0.124 log(X) (bacterial count, 10(9) cells/L); r = 0.243. Albuminuria correlated moderately with NGAL values: log(Y) (NGAL, mu g/L) = 1.557 + 0.339 log(X) (albuminuria, mg/L); r = 0.368; alpha(1)-microglobulin (a1M) correlated weakly with NGAL: log(Y) (NGAL, mu g/L) = 1.631 + 0.360 log(X) (a1M, mg/L); r = 0.381. 
Conclusions: Leukocyte contributions to urinary NGAL concentrations can be important. In leukocyturia or tubular damage (e. g., intensive care patients), using a fixed cut-off value for interpreting urinary NGAL data can lead to false positive results. Therefore, we suggest a mathematical correction in cases with pyuria ({\textrangle} 100 x 1(0)9 cells/L) and urinary NGAL concentration {\textrangle} 100 mu g/L: corrected NGAL (mu g/L) = NGAL-0.12 (urinary WBC, 10(9) cells/L).},
  author       = {Decavele, An-Sofie and Dhondt, Lien and De Buyzere, Marc and Delanghe, Joris},
  issn         = {1434-6621},
  journal      = {CLINICAL CHEMISTRY AND LABORATORY MEDICINE},
  keyword      = {ACUTE KIDNEY INJURY,BIOMARKER,PROTEINS,PATHOLOGY,NEPHROPATHY,NGAL,urinary tract infection,neutrophil gelatinase associated lipocalin (NGAL),leukocytes,alpha(1)-microglobulin,albuminuria,acute kidney injury,CHILDREN,IRON},
  language     = {eng},
  number       = {6},
  pages        = {999--1003},
  title        = {Increased urinary neutrophil gelatinase associated lipocalin in urinary tract infections and leukocyturia},
  url          = {http://dx.doi.org/10.1515/CCLM.2011.156},
  volume       = {49},
  year         = {2011},
}

Chicago
Decavele, An-Sofie, Lien Dhondt, MARC DE BUYZERE, and Joris Delanghe. 2011. “Increased Urinary Neutrophil Gelatinase Associated Lipocalin in Urinary Tract Infections and Leukocyturia.” Clinical Chemistry and Laboratory Medicine 49 (6): 999–1003.
APA
Decavele, A.-S., Dhondt, L., DE BUYZERE, M., & Delanghe, J. (2011). Increased urinary neutrophil gelatinase associated lipocalin in urinary tract infections and leukocyturia. CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 49(6), 999–1003.
Vancouver
1.
Decavele A-S, Dhondt L, DE BUYZERE M, Delanghe J. Increased urinary neutrophil gelatinase associated lipocalin in urinary tract infections and leukocyturia. CLINICAL CHEMISTRY AND LABORATORY MEDICINE. 2011;49(6):999–1003.
MLA
Decavele, An-Sofie, Lien Dhondt, MARC DE BUYZERE, et al. “Increased Urinary Neutrophil Gelatinase Associated Lipocalin in Urinary Tract Infections and Leukocyturia.” CLINICAL CHEMISTRY AND LABORATORY MEDICINE 49.6 (2011): 999–1003. Print.