TY - JOUR
T1 - Plasma neutrophil gelatinase-associated lipocalin as a predictive biomarker for the detection of acute kidney injury in adult poisoning
AU - Ahn, Jae Yun
AU - Lee, Mi Jin
AU - Seo, Jun Seok
AU - Choi, Daihai
AU - Park, Jeong Bae
N1 - Publisher Copyright:
© 2015 Taylor & Francis.
PY - 2016/2/7
Y1 - 2016/2/7
N2 - Context: Acute kidney injury (AKI) is a serious complication in intoxicated patients. Recently, a new biomarker - neutrophil gelatinase-associated lipocalin (NGAL) - was used to predict AKI in patients who were critically ill or had sepsis. Objective: To evaluate the utility of plasma NGAL as an early predictor of AKI in adults with acute poisoning. Materials and methods: This retrospective, observational, cohort study was conducted between December 2013 and November 2014. A total of 157 consecutive adult patients who presented to the emergency department (Level 1 regional center) of Kyungpook National University Hospital, a tertiary teaching hospital in Daegu, Korea, within 24 h of poisoning were included. Initial plasma NGAL levels and laboratory parameters were concurrently measured upon hospital arrival. AKI was defined according to Acute Kidney Injury Network criteria. Development of AKI was predicted using plasma NGAL levels and by analyzing the area under the receiver operating characteristic curve (AUC). Results: The overall rate of AKI was 14.6% (n = 23). Plasma NGAL levels in the AKI group were higher than those in the non-AKI group (median, 310 vs. 86 ng/mL; p <0.001). Additionally, baseline NGAL levels allowed for better prediction of AKI than initial creatinine levels. The AUC of plasma NGAL was 0.895 (95% confidence interval [CI]: 0.832-0.941), with a cut-off value of 227 ng/mL (sensitivity, 76.2%; specificity, 95.8%). Plasma NGAL had a higher predictive capacity for AKI than serum creatinine (AUC 0.741, 95% CI: 0.662-0.810), base deficit (AUC 0.795, 95% CI: 0.701-0.870), lactate (AUC 0.781, 95% CI: 0.690-0.856), and anion gap (AUC 0.636, 95% CI: 0.535-0.730). Conclusion: Plasma NGAL may serve as a good predictor of AKI in cases of adult poisoning.
AB - Context: Acute kidney injury (AKI) is a serious complication in intoxicated patients. Recently, a new biomarker - neutrophil gelatinase-associated lipocalin (NGAL) - was used to predict AKI in patients who were critically ill or had sepsis. Objective: To evaluate the utility of plasma NGAL as an early predictor of AKI in adults with acute poisoning. Materials and methods: This retrospective, observational, cohort study was conducted between December 2013 and November 2014. A total of 157 consecutive adult patients who presented to the emergency department (Level 1 regional center) of Kyungpook National University Hospital, a tertiary teaching hospital in Daegu, Korea, within 24 h of poisoning were included. Initial plasma NGAL levels and laboratory parameters were concurrently measured upon hospital arrival. AKI was defined according to Acute Kidney Injury Network criteria. Development of AKI was predicted using plasma NGAL levels and by analyzing the area under the receiver operating characteristic curve (AUC). Results: The overall rate of AKI was 14.6% (n = 23). Plasma NGAL levels in the AKI group were higher than those in the non-AKI group (median, 310 vs. 86 ng/mL; p <0.001). Additionally, baseline NGAL levels allowed for better prediction of AKI than initial creatinine levels. The AUC of plasma NGAL was 0.895 (95% confidence interval [CI]: 0.832-0.941), with a cut-off value of 227 ng/mL (sensitivity, 76.2%; specificity, 95.8%). Plasma NGAL had a higher predictive capacity for AKI than serum creatinine (AUC 0.741, 95% CI: 0.662-0.810), base deficit (AUC 0.795, 95% CI: 0.701-0.870), lactate (AUC 0.781, 95% CI: 0.690-0.856), and anion gap (AUC 0.636, 95% CI: 0.535-0.730). Conclusion: Plasma NGAL may serve as a good predictor of AKI in cases of adult poisoning.
KW - Acute kidney injury
KW - diagnosis
KW - neutrophil gelatinase-associated lipocalin
KW - poisoning
UR - http://www.scopus.com/inward/record.url?scp=84955679696&partnerID=8YFLogxK
U2 - 10.3109/15563650.2015.1118487
DO - 10.3109/15563650.2015.1118487
M3 - Article
C2 - 26683351
AN - SCOPUS:84955679696
SN - 1556-3650
VL - 54
SP - 127
EP - 133
JO - Clinical Toxicology
JF - Clinical Toxicology
IS - 2
ER -