급성신손상 환자에서 진단과 예후의 생체지표로서 혈청 NGAL 의 역할

Abstract

Background and Objectives : Acute kidney injury (AKI) is a common and serious condition, the diagnosis of which currently depend on functional markers such as serum creatinine measurement. Unfortunately, creatinine is a delayed and unreliable indicator of AKI. Neutrophil gelatinase-associated lopocalin (NGAL) appears to be a promising novel biomarker for the early diagnosis of acute kidney injury (AKI). however, a wide range in its predictive value has been reported. The aim of this study was to evaluate the predictive value of serum NGAL in patients with established AKI Materials and Methods : Serum NGAL was measured in 1293 patient with AKI. AKI was diagnosed according to AKIN criteria. Patients were four group; group 1 includes patients with normal renal function, group 2 includes patients with AKIN stage 1, group 3 includes patients with AKIN stage 2, group 4 includes patients with AKIN stage 3 . Serum NGAL were measured by ELISA at admission. We studied possible relationship between serum NGAL, estimated glomerular filtration rate (eGFR), and staging in patient with AKI. Results : Serum NGAL levels were significantly higher in AKI patient than in healthy control (452.19±471.57 ng/mL vs. 183.12±259.46 ng/mL , p<0.001). The serum NGAL level showed a significant inversed correlation with GFR (r= 0.164, p=0.018). The discriminatory ability of NGAL for AKI also increased with increasing AKIN stage. (AKIN1, 159.0 (77.5-425.5), AKIN2 56.0 (52.0-548.0), AKIN3 503.5 (88.0-1300), p<0.001). Conclusion : From this results, we concluded that serum NGAL is a reliable marker of renal function in AKI patient. However, serum NGAL did not provide more accurate information regarding renal function.

Key word : Neutrophil gelatinase-associated lopocalin, acute kidney injury, biomarker