Advanced search
1 file | 897.79 KB Add to list

Influence of severity of illness on neutrophil gelatinase-associated lipocalin performance as a marker of acute kidney injury : a prospective cohort study of patients with sepsis

Jill Vanmassenhove (UGent) , Griet Glorieux (UGent) , Norbert Lameire (UGent) , Eric Hoste (UGent) , Annemieke Dhondt (UGent) , Raymond Vanholder (UGent) and Wim Van Biesen (UGent)
Author
Organization
Abstract
Background: The role of neutrophil gelatinase-associated lipocalin (NGAL) as a diagnostic marker for acute kidney injury (AKI) in sepsis is still debated. We hypothesized that in sepsis, the performance of serum(s) and urinary(u) NGAL can be negatively impacted by severity of illness and inflammation, and that both uNGAL and sNGAL levels can be increased regardless of presence of AKI. Methods: One hundred and seven patients with sepsis were included. uNGAL and sNGAL were measured at admission (T0) and 4 hours (T4) and 24 hours later (T24). Transient and intrinsic AKI were respectively defined as AKI according to RIFLE during the first 72 hours that did or did not recover to "no AKI" in the following 72 hours. Patients were classified according to tertiles of CRP and APACHE II score increase. The relationship between sNGAL and uNGAL was assessed by linear regression. Results: Fifty-seven patients developed transient and 22 intrinsic AKI. Prevalence of transient and intrinsic AKI were higher in patients with versus without septic shock (OR (95% CI): 3.3(1.4-8.2)). uNGAL was associated with sNGAL, and this with parallel slopes but different intercepts for AKI (Y = 0.87*X + 314.3, R-2 = 0.31) and no AKI (Y = 0.87*X + 20.1, R-2 = 0.38). At T4, median uNGAL and sNGAL levels were higher in septic patients with versus without shock but this is independent of AKI ((545 ng/mL vs 196 ng/ml for uNGAL and 474 ng/ml vs 287 ng/ml for sNGAL (both P = 0.003)). Both uNGAL and sNGAL levels increased with tertiles of CRP and APACHE II score increase. Conclusions: Serum and uNGAL levels are influenced by severity of illness and inflammation, and this was found to be independent of the presence of AKI. There is a strong correlation between sNGAL and uNGAL levels in patients with sepsis, indicating that increased levels of uNGAL can also be due to overspill from the systemic circulation, blurring the discriminative value of NGAL as a biomarker for AKI in patients with sepsis.
Keywords
CONSENSUS CONFERENCE, RENAL BLOOD-FLOW, CRITICALLY-ILL PATIENTS, NGAL, Acute kidney injury, Sepsis, SUSPECTED SEPSIS, BIOMARKERS, FAILURE, URINE, HNL/NGAL, NGAL

Downloads

  • BMC Nephrology 2015 issue16 pg18.pdf
    • full text
    • |
    • open access
    • |
    • PDF
    • |
    • 897.79 KB

Citation

Please use this url to cite or link to this publication:

MLA
Vanmassenhove, Jill et al. “Influence of Severity of Illness on Neutrophil Gelatinase-associated Lipocalin Performance as a Marker of Acute Kidney Injury : a Prospective Cohort Study of Patients with Sepsis.” BMC NEPHROLOGY 16 (2015): n. pag. Print.
APA
Vanmassenhove, J., Glorieux, G., Lameire, N., Hoste, E., Dhondt, A., Vanholder, R., & Van Biesen, W. (2015). Influence of severity of illness on neutrophil gelatinase-associated lipocalin performance as a marker of acute kidney injury : a prospective cohort study of patients with sepsis. BMC NEPHROLOGY, 16.
Chicago author-date
Vanmassenhove, Jill, Griet Glorieux, Norbert Lameire, Eric Hoste, Annemieke Dhondt, Raymond Vanholder, and Wim Van Biesen. 2015. “Influence of Severity of Illness on Neutrophil Gelatinase-associated Lipocalin Performance as a Marker of Acute Kidney Injury : a Prospective Cohort Study of Patients with Sepsis.” Bmc Nephrology 16.
Chicago author-date (all authors)
Vanmassenhove, Jill, Griet Glorieux, Norbert Lameire, Eric Hoste, Annemieke Dhondt, Raymond Vanholder, and Wim Van Biesen. 2015. “Influence of Severity of Illness on Neutrophil Gelatinase-associated Lipocalin Performance as a Marker of Acute Kidney Injury : a Prospective Cohort Study of Patients with Sepsis.” Bmc Nephrology 16.
Vancouver
1.
Vanmassenhove J, Glorieux G, Lameire N, Hoste E, Dhondt A, Vanholder R, et al. Influence of severity of illness on neutrophil gelatinase-associated lipocalin performance as a marker of acute kidney injury : a prospective cohort study of patients with sepsis. BMC NEPHROLOGY. 2015;16.
IEEE
[1]
J. Vanmassenhove et al., “Influence of severity of illness on neutrophil gelatinase-associated lipocalin performance as a marker of acute kidney injury : a prospective cohort study of patients with sepsis,” BMC NEPHROLOGY, vol. 16, 2015.
@article{6884798,
  abstract     = {Background: The role of neutrophil gelatinase-associated lipocalin (NGAL) as a diagnostic marker for acute kidney injury (AKI) in sepsis is still debated. We hypothesized that in sepsis, the performance of serum(s) and urinary(u) NGAL can be negatively impacted by severity of illness and inflammation, and that both uNGAL and sNGAL levels can be increased regardless of presence of AKI. 
Methods: One hundred and seven patients with sepsis were included. uNGAL and sNGAL were measured at admission (T0) and 4 hours (T4) and 24 hours later (T24). Transient and intrinsic AKI were respectively defined as AKI according to RIFLE during the first 72 hours that did or did not recover to "no AKI" in the following 72 hours. Patients were classified according to tertiles of CRP and APACHE II score increase. The relationship between sNGAL and uNGAL was assessed by linear regression. 
Results: Fifty-seven patients developed transient and 22 intrinsic AKI. Prevalence of transient and intrinsic AKI were higher in patients with versus without septic shock (OR (95% CI): 3.3(1.4-8.2)). uNGAL was associated with sNGAL, and this with parallel slopes but different intercepts for AKI (Y = 0.87*X + 314.3, R-2 = 0.31) and no AKI (Y = 0.87*X + 20.1, R-2 = 0.38). At T4, median uNGAL and sNGAL levels were higher in septic patients with versus without shock but this is independent of AKI ((545 ng/mL vs 196 ng/ml for uNGAL and 474 ng/ml vs 287 ng/ml for sNGAL (both P = 0.003)). Both uNGAL and sNGAL levels increased with tertiles of CRP and APACHE II score increase. 
Conclusions: Serum and uNGAL levels are influenced by severity of illness and inflammation, and this was found to be independent of the presence of AKI. There is a strong correlation between sNGAL and uNGAL levels in patients with sepsis, indicating that increased levels of uNGAL can also be due to overspill from the systemic circulation, blurring the discriminative value of NGAL as a biomarker for AKI in patients with sepsis.},
  articleno    = {18},
  author       = {Vanmassenhove, Jill and Glorieux, Griet and Lameire, Norbert and Hoste, Eric and Dhondt, Annemieke and Vanholder, Raymond and Van Biesen, Wim},
  issn         = {1471-2369},
  journal      = {BMC NEPHROLOGY},
  keywords     = {CONSENSUS CONFERENCE,RENAL BLOOD-FLOW,CRITICALLY-ILL PATIENTS,NGAL,Acute kidney injury,Sepsis,SUSPECTED SEPSIS,BIOMARKERS,FAILURE,URINE,HNL/NGAL,NGAL},
  language     = {eng},
  pages        = {10},
  title        = {Influence of severity of illness on neutrophil gelatinase-associated lipocalin performance as a marker of acute kidney injury : a prospective cohort study of patients with sepsis},
  url          = {http://dx.doi.org/10.1186/s12882-015-0003-y},
  volume       = {16},
  year         = {2015},
}

Altmetric
View in Altmetric
Web of Science
Times cited: