scholarly journals Urine neutrophil gelatinase-associated lipocalin (NGAL) measurement is not predictive for ureteral patency in pediatric patients following pyeloplasty: a pilot study

2021 ◽  
Vol 42 (1) ◽  
pp. 63-68
Author(s):  
Varathon Lumyai ◽  
◽  
Nattachai Srisawat ◽  
Promwong Ngamwuttiwong ◽  
Chanatee Bunyaratavej ◽  
...  
Keyword(s):  
Pilot Study ◽  
Large Scale ◽  
Pediatric Patients ◽  
P Value ◽  
Ngal Level ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Significant Difference ◽  
Neutrophil Gelatinase ◽  
Bladder Urine

Objective: To evaluate the benefit of urine neutrophil gelatinase-associated lipocalin (NGAL) measurement to predict the ureteral patency in pediatric patients undergoing pyeloplasty. Materials and Methods: Ureteropelvic junction obstruction patients who underwent unilateral dismembered pyeloplasty had urine NGAL measurements taken intraoperatively during pyeloplasty and postoperatively at six months following surgery. All patients were evaluated preoperatively and postoperatively with renal scans. Pairwise comparisons and correlation analyses were performed to determine the dynamics and benefits of urine NGAL measurement. Results: Thirteen patients were included in this pilot study with a mean age of 3.2 years at surgery. Mean intraoperative bladder urine level was 4.43 ng/mL, and median intraoperative renal pelvic urine NGAL level was 3.70 ng/mL. There was no significant difference between these two levels (p-value = 0.76). Six months after pyeloplasty, 9/13 patients demonstrated significant reduction in the bladder urine NGAL level (at least 50% reduction), and 5/13 patients showed ureteral patency based on postoperative renal scan (more than 5% improvement in differential renal function or the conversion of diuretic half time. However, the finding of significant reduction of urine NGAL level did not correlate with ureteral patency (r = -0.50, p-value = 0.08). Conclusion: Although bladder urine NGAL level reduces in most pediatric patients following pyeloplasty, this decline is not reflective of the finding of ureteral patency from renal scanning. The benefits of urine NGAL measurement in this context remain unclear and require further large-scale investigation.

scholarly journals LEVEL OF NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) URIN AS A PREDICTOR OF ACUTE KIDNEY INJURY IN SEPSIS PATIENTS TREATED IN ICU H.ADAM MALIK MEDAN HOSPITAL

2020 ◽  
pp. 1-5
Author(s):  
Yudhistira Yudhistira ◽  
Burhanuddin Nasution* ◽  
Achsanuddin Hanae ◽  
Nindia Sugih Arto
Keyword(s):  
Kidney Injury ◽  
Rank Test ◽  
P Value ◽  
Ngal Level ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
A Value ◽  
Early Biomarker ◽  
Level 1 ◽  
Neutrophil Gelatinase

BACKGROUND: Sepsis is a complex interaction between the direct toxic effects of infecting microor ganisms and the disruption of the host's normal inammatory response to infection. One organ that is often disrupted is the kidney . Neutrophil Gelatinase-Associated Lipocalin (NGAL) is an AKI biomarker that can be used as an early biomarker for AKI prediction, monitoring clinical trials in AKI and for the prognosis of AKI. METHOD: This research is an observational study. 30 subjects with sepsis were examined for PCT, BUN, urea, creatinine and urine NGAL tests. RESULTS: Statistical analysis using the Spearman Rank Test shows that NGAL level 1 has a signicant relationship with PCT day 1, with a value (r = 0.912) and a value of p <0.05. NGAL level day 1 did not have a signicant relationship with levels of urea, creatinine, BUN with values (r = 0.113), (r = 0.329), (r = 0.352) and values (p> 0.05). NGAL day 3 had a signicant relationship with PCT day 1, with a value (r = 0.0771) and a p value <0.001. Measurement of NGAL day 3 had a signicant relationship with urea, creatinine, BUN, and values (r = 0.427), (r = 0.550), (r = 0.411) with a p value <0.05. CONCLUSIONS AND RECOMMENDATIONS: From the results of the study, it was concluded that there was a difference between urine NGAL levels in septic patients on day 1 (197.26 ± 118.54) and day 3 (288.31 ± 136.96). There was a signicant correlation between urinary NGAL levels with urea levels (p = 0.024 & r = 0.427) and creatinine (p = 0.002 & r = 0.550) on day 3, so urine NGAL was a predictor of AKI events in sepsis patients on day 1 -3..

scholarly journals Comparison of urine and serum neutrophil gelatinase-associated lipocalin after open and endovascular thoraco-abdominal aortic surgery and their meaning as indicators of acute kidney injury

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Alexander Gombert ◽  
Lukas Martin ◽  
Ann Christina Foldenauer ◽  
Clara Krajewski ◽  
Andreas Greiner ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Aortic Aneurysms ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Abdominal Aortic ◽  
Potential Biomarker ◽  
Significant Difference ◽  
Neutrophil Gelatinase

Abstract. Background: Neutrophil gelatinase-associated lipocalin (NGAL) has been described as a potential biomarker of acute kidney injury (AKI) in different settings, but its behaviour under influence of open and endovascular repair of thoraco-abdominal aortic aneurysms (TAAA) has not been assessed yet. In this study, the course of NGAL was observed and differences of serum- (sNGAL) and urine-NGAL (uNGAL) levels following TAAA repair, especially with regard to AKI, were evaluated. Patients and methods: In this retrospective single centre study, 52 patients (mean age 64.5 years, [43–85 years]), including 39 (75 %) men, were enrolled (2014–2015, 13.2 months mean follow-up). Levels of sNGAL and uNGAL were measured perioperatively for 48 hours on intensive care unit. Twenty-three patients were treated by endovascular and 29 by open TAAA-repair. Results: Logistic regression revealed an increase in NGAL (sNGAL p = 0.0263, uNGAL p = 0.0080) corresponding with an increase in serum creatinine within the first 48 hours. Fourteen patients (26.9 %) developed AKI and 11 (21.1 %) required dialysis. The course of NGAL differed significantly (uNGAL p < .0001, sNGAL p = 0.0002) between patients suffering from AKI requiring dialysis and patients without AKI. The predictive power of uNGAL was three times higher than that of sNGAL (estimate of the regression slope 0.1382 vs. 0.0460). No significant difference between patients undergoing open or endovascular TAAA repair regarding the perioperative course of sNGAL and uNGAL was observed. Conclusion: serum-NGAL and urine-NGAL correlate with serum creatinine levels and AKI requiring dialysis. Furthermore, the postoperative course of sNGAL and uNGAL after open and endovascular TAAA repair is not significantly different. Taken together, the results indicate that uNGAL and, to a lesser extent, sNGAL could be considered biomarkers for early detection of perioperative AKI after open and endovascular TAAA surgery.

scholarly journals Serum Neutrophil Gelatinase-Associated Lipocalin Levels In Early Detection Of Contrast-Induced Nephropathy

2016 ◽  
Vol 39 (3) ◽  
pp. 88 ◽  
Author(s):  
Murat Muratoglu ◽  
Cemil Kavalci ◽  
Elif Kilicli ◽  
Meliha Findik ◽  
Afşin Emre Kayipmaz ◽  
...  
Keyword(s):  
Early Detection ◽  
P Value ◽  
Ngal Level ◽  
Contrast Induced Nephropathy ◽  
Sodium Potassium ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
The Mean ◽  
Neutrophil Gelatinase ◽  
Over Time

Purpose: The purpose of this study was to investigate the role of serum neutrophil gelatinase-associated lipocalin (NGAL) levels in the early detection of contrast-induced nephropathy (CIN). Methods: This prospective study enrolled 74 patients undergoing abdominal tomography with contrast (1 November 2014 - 28 February 2015). Demographic properties (age and sex), symptoms and CT examination results were analysed. Sodium, potassium, urea, creatinine and NGAL levels were measured at 0th, 6th, and 72nd hours. P value < 0.05 was considered statistically significant. Results: CIN developed in 16.2% of the study patients. The mean age was significantly higher in the patients who developed CIN (p0.05). Urea levels did not differ significantly between the groups at 0th and 6th hours (p>0.05) but was significantly higher in the patients with CIN at 72nd hour (p0.05). Creatinine level was not significantly different between the groups (p>0.05) but increased significantly over time (p>0.05). There were no significant differences between the groups with respect to NGAL levels at 0th and 72nd hours (p>0.05) whereas the group with CIN had a significantly higher NGAL level at 6th hour (p

Correlation between neutrophil gelatinase-associated lipocalin and soluble CD14 subtype on the prognosis evaluation of acute paraquat poisoning patients

2020 ◽  
Vol 39 (4) ◽  
pp. 402-410
Author(s):  
X Gao ◽  
W-Z Wang ◽  
Q-M Xiao ◽  
H-N Qi ◽  
B-Y Zhu ◽  
...  
Keyword(s):  
Apache Ii ◽  
Apache Ii Score ◽  
Control Group ◽  
Ngal Level ◽  
Urine Ngal ◽  
Soluble Cd14 ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Paraquat Poisoning ◽  
Neutrophil Gelatinase ◽  
Prognosis Evaluation

Objective: The objective of this article is to study the correlation between neutrophil gelatinase-associated lipocalin (NGAL) and soluble CD14 subtype (presepsin) on the severity and prognosis evaluation of acute paraquat poisoning (APP) patients. Materials and methods: We studied 120 APP patients who were divided into three groups: light (28 cases), moderate (52 cases), and heavy poisoning (40 cases) groups. Twenty healthy volunteers were enrolled as controls. Results: Acute kidney injury (AKI) occurred in 86 APP patients (71.7%, 86 of 120). In AKI group, urine NGAL was elevated 3 h after treatment, serum NGAL was elevated 24 h after treatment, and serum creatine (SCr) was elevated 2 days after treatment, which were all significantly higher than non-AKI group. Compared with control group, there were significant differences in presepsin and acute physiology and chronic health status (APACHE) II score of different poisoning groups. There were significant differences in detection indices 24 h, 3 days, and 7 days after treatment among different poisoning groups. There was a positive correlation between urine NGAL and serum paraquat concentration, urine NGAL, and AKI morbidity ( r 1 = 0.974, r 2 = 0.766, p < 0.001), suggesting higher urine NGAL level indicated higher AKI morbidity. Receiver operating characteristic curves analysis suggested serum presepsin level and urine NGAL level had higher sensitivity and specificity than APACHE II score when predicting 28-day mortality of APP patients. Conclusion: Serum and urine NGAL level is elevated earlier than SCr, which is important for the early diagnosis of APP. Serum presepsin and urine NGAL levels can be used as markers to diagnose the severity of AKI and predict the mortality of APP patients.

scholarly journals Urine neutrophil gelatinase-associated lipocalin concentration in healthy newborns during the first three postnatal days

2020 ◽  
Vol 30 (3) ◽  
pp. 466-470
Author(s):  
Vinka Mikulić ◽  
Ivanka Mikulić ◽  
Helena Radić Mišković ◽  
Vajdana Tomić ◽  
Ana Ćuk ◽  
...  
Keyword(s):  
Birth Weight ◽  
Biochemical Marker ◽  
Kidney Injury ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Median Concentration ◽  
Significant Difference ◽  
Term Newborns ◽  
Chemiluminescent Microparticle Immunoassay ◽  
Neutrophil Gelatinase

Introduction: Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a biochemical marker significant for early prediction of acute kidney injury in adults. However, it has not been examined sufficiently among the infant population, particularly newborns in terms of reference values. The aim of our study was to determine the concentration of uNGAL in healthy term newborns and to determine if there was a difference in uNGAL concentration according to gender, postnatal age and birth weight. Materials and methods: Our study involved 81 healthy term newborns birth (≥ 37 weeks, Apgar score ≥ 8 in the first minute after birth, CRP < 5 mg/L). Urine NGAL was measured using chemiluminescent microparticle immunoassay (CMIA) within 72 hours after birth, on Architect plus ci8200 analyser (Abbott, Chicago, USA). Data were analysed using Statistica software. Results: The median concentration of uNGAL in the whole study group of healthy term newborns was 27.1 ng/mL (16.5-56.0 ng/mL) (newborn girls, 27.1 ng/mL (15.8-47.9 ng/mL); newborn boys, 27.9 ng/mL (16.5-61.0 ng/mL), P = 0.941). Median uNGAL concentration according to postnatal age expressed in days was 28.2 ng/mL (11.7-57.2 ng/mL) 1st day, 28.9 ng/mL (16.5-64.2 ng/mL ) 2nd day and 23.9 ng/mL (20.2-46.6) 3rd day, P = 0.863. Regarding birth weight for newborns < 3500 g, median concentration was 25.0 ng/mL (16.5-45.4 ng/mL ) and for weight ≥ 3500 g 30.6 ng/mL (16.5-64.2 ng/mL), P = 0.455. Conclusions: There were no significant difference in uNGAL concentration in relation to gender, postnatal age and birth weight.

scholarly journals The effectiveness of raising Hong Kong parents’ awareness of antimicrobial resistance through an educational program with peer support on social media: A pilot study

2021 ◽  
Author(s):  
Peggy P.L. Or ◽  
Patricia T.Y. Ching
Keyword(s):  
Social Media ◽  
Pilot Study ◽  
Antimicrobial Resistance ◽  
Peer Support ◽  
Large Scale ◽  
Intervention Program ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Significant Difference

Abstract Background To test whether parents’ awareness of antimicrobial resistance could be improved through the education programme with peer support on social media Methods A cluster randomized controlled trial with two-arms were implemented. The intervention program consisted of two weekly sessions and each session lasted for 90 minutes. A total of 48 parents had participated in the program. Parental knowledge, attitude, and their social network were measured before and after the program using the Parental Perception on Antibiotics (PAPA) scale and the General Self-Efficacy Scale (GSE) to assess differences between and within the intervention and control groups. Results All parents would have a sense that antibiotics could be effective at treating some infections and not others, as compared to 40% in the control group. All parents in the intervention group and 85% of the control group disagreed that they should reduce the dose of antibiotics when their children were recovering. The test was statistically significant (p = 0.039) with a p value < .05. There was a significant difference and a strong negative correlation between peer support in Facebook and the parents’ belief that antibiotics could be stopped when their children felt better, with Pearson coefficient of -0.78 and p = 0.001. In general, there was no significant difference between the two groups with respect to the GSE scale. Conclusions Based on the findings in this pilot study, a further study based on the education program with enhancement and peer support can be implemented in a large scale with a positive expectation of increasing parental awareness of antimicrobial resistance and potentially influencing patient prescribing expectations when seeking healthcare.

Evaluation of Neutrophil Gelatinase-Associated Lipocalin in Children with Sydenham's Chorea Accompanying Valvular Regurgitation

2018 ◽  
Vol 13 (04) ◽  
pp. 293-299
Author(s):  
Köksal Deveci ◽  
Ahmet Guven ◽  
Demet Alaygut ◽  
Mehmet Oflaz
Keyword(s):  
Immune Response ◽  
Total Protein ◽  
Valvular Regurgitation ◽  
Urinary Ngal ◽  
Creatinine Ratio ◽  
Ngal Level ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Sydenham's Chorea ◽  
Neutrophil Gelatinase

Background Acute rheumatic fever (ARF) is a nonsuppurative complications of Group A β-hemolytic streptococcal (GABHS) infection due to a delayed immune response. Sydenham's chorea (SC) is an important neurological manifestation of ARF, and heart involvement is seen in a large proportion of patients with SC. The immune system has a crucial role in initiating and spreading inflammation, which causes tissue damage in ARF. Aim The purpose of this study was to investigate urine neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for kidney injury in children with rheumatic chorea accompanying valvular involvement. Materials and Methods Twenty-eight consecutive children with SC accompanying evidence of valvular involvement, and 30 nonrheumatic, age- and sex-matched healthy children were included in the study. Cardiac evaluations were performed, and urinary NGAL, micro-total protein and creatinine levels were measured in all participants. Results Age, gender, weight, and height were similar in the patients and controls. Twenty-three patients had isolated mitral regurgitation, and five patients had mitral and aortic regurgitation. While there was no statistically significant difference between the urine creatinine and micro-total protein levels in patients and controls, the patient group demonstrated a significantly higher mean urine NGAL level (18.01 ± 7.9 vs. 3.22 ± 1.4, p = 0.002) and mean urine NGAL/creatinine ratio (2.80 ± 1.9 vs. 0.33 ± 0.1, p = 0.008). However, there were no correlations between severity of chorea and urinary NGAL or urinary NGAL/creatinine ratio, there were significant positive correlations between severity of valvular regurgitation and urinary NGAL (r = 0.751, p < 0.001) and urinary NGAL/creatinine ratio (r = 0.694, p < 0.001). Conclusion The present study revealed that urinary NGAL level and urinary NGAL/creatinine ratio were higher in patients with SC accompanying valvular involvement. The results obtained from this study suggest that ARF may cause subclinical renal injury in patients with intense and prolonged cellular immune response leading to chorea and carditis.

scholarly journals The Effect of Intravenous Vitamin C on Urine Neutrophil Gelatinase-Associated Lipocalin Among Septic Patients

2019 ◽  
Vol 3 (4) ◽  
pp. 21-28
Author(s):  
Peni Yulia Nastiti ◽  
Adhrie Sugiharto ◽  
Amir S Madjid
Keyword(s):  
Vitamin C ◽  
Repeated Measurement ◽  
P Value ◽  
Inflammatory Biomarker ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Significant Difference ◽  
Group A ◽  
Intravenous Vitamin ◽  
Group B ◽  
Neutrophil Gelatinase

Background The role of vitamin C to decrease organ dysfunction in sepsis was still controversial. This study aimed to explore the effect of intravenous (IV) vitamin C on urine NGAL (uNGAL) levels among septic patients in ICU. Methods This study was a randomized clinical trial held in Cipto Mangunkusumo Hospital from April to July 2019 with consecutive sampling method. Patients aged > 18 years with sepsis based on the criteria of sepsis-3 who were admitted to the ICU were included in this study. Exclusion criteria were those with chronic kidney problems, with kidney stones, undergo renal replacement therapy in the ICU. All subjects were divided into: Group A was treated  with combination of vitamin C and thiamine while Group B was given thiamine only. The uNGAL level was measured at baseline, 24, 48 and 72 h after treatment. Anova for repeated measurement using General Linear Model for Repeated Measurement was used with level of significant at p-value <0.05. Results Total of 33 subjects were included. In Group A we found uNGAL (ng/ mL) were 74.5 (13.3-102.9), 77.3 (15.2-98.4), 67.2 (22.6-100.6), 77.2 (17.0-100.5) for baseline, 24 h, 48 h, and 72 h respectively. While in Group B uNGAL were 57.7 (11.5-94.5), 57.1 (6.4-97.7), 53.7 (13.3-99.6), 47.6 (4.5-100.9). No significant difference in terms of uNGAL between two groups at each hour was found. Conclusions This study showed that intravenous vitamin C administration had no effect on uNGAL among septic patients. Need more study to investigate approaches to improve kidney and inflammatory biomarker among septic patients.

scholarly journals Neutrophil gelatinase–associated lipocalin as a biomarker of nephropathy in sickle cell disease

2021 ◽  
Author(s):  
Rajaa Marouf ◽  
Adekunle D. Adekile ◽  
Hadeel El-Muzaini ◽  
Rasha Abdulla ◽  
Olusegun A. Mojiminiyi
Keyword(s):  
Steady State ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Roc Curve ◽  
Screening Tests ◽  
Cell Disease ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Plasma Ngal ◽  
Neutrophil Gelatinase

AbstractSickle cell nephropathy (SCN) develops via altered hemodynamics and acute kidney injury, but conventional screening tests remain normal until advanced stages. Early diagnostic biomarkers are needed so that preventive measures can be taken. This study evaluates the role of neutrophil gelatinase–associated lipocalin (NGAL) as a biomarker of SCN in steady state and vaso-occlusive crisis (VOC). In this case-control study, 74 sickle cell disease (SCD) patients (37 in steady state and 37 in VOC) and 53 control subjects had hematological and biochemical measurements including plasma and urine NGAL. Univariate and logistic regression analyses were used to find the associations between variables. The receiver operating characteristic (ROC) curve was used to determine the diagnostic performance characteristics of plasma and urine NGAL for detection of VOC. Plasma and urine NGAL, urine microalbumin:creatinine ratio, and urine protein:creatinine ratio were significantly higher in VOC. Microalbuminuria was present in 17.1% steady state and 32.0% VOC patients. Microalbuminuria showed significant correlations with age, plasma NGAL, WBC, and hemolytic parameters. Area under the ROC curve for plasma NGAL was 0.69 (95%CI = 0.567–0.813; p = 0.006) and 0.86 (95%CI = 0.756–0.954; p < 0.001) for urine NGAL. Urine NGAL cut-off value of 12.0 ng/mL had 95% sensitivity and 65% specificity. These results confirm the presence of nephropathy during VOC and suggest that plasma and urine NGAL would be useful in the identification of SCN. Urine NGAL should be used as the screening biomarker, and patients with VOC and urine NGAL > 12.0 ng/mL should be selected for aggressive management to prevent progression of renal damage.

scholarly journals Neutrophil-Gelatinase Associated Lipocalin (N-GAL) to Assess Perioperative Acute Kidney Injury in Hand-Assisted Laparoscopic Donor Nephrectomy: A Pilot Study

2015 ◽  
Vol 13 (1) ◽  
pp. 39-41
Author(s):  
Emma Aitken ◽  
Alex Vesey ◽  
Julie Glen ◽  
Mark Steven ◽  
Marc Clancy
Keyword(s):  
Acute Kidney Injury ◽  
Pilot Study ◽  
Fluid Management ◽  
Kidney Injury ◽  
Donor Nephrectomy ◽  
Live Donor ◽  
Baseline Serum ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Live Donor Nephrectomy ◽  
Neutrophil Gelatinase

Abstract Perioperative insults, including hypotension, hypovolaemia and pneumoperitoneum may occur during laparoscopic live donor nephrectomy. These may have deleterious effects to both donor and recipient. The extent and significance of these insults is poorly understood and difficult to quantify. The aim of this study was to evaluate acute kidney injury (AKI) in the donor using the novel biomarker neutrophil-gelatinase associated lipocalin (N-GAL). We report the results of a pilot study of 20 patients undergoing hand-assisted live donor nephrectomy. eGFR and serum NGAL measurements (Triage CardioRenal Panel, Alere) were obtained preoperatively, immediately post-operatively, day 1 and 6 weeks post-operatively. Mean pre-operative eGFR was 105.6+/-10.1ml/min/1.73m2. Mean eGFR 6 weeks postoperatively demonstrated a 29.4+/-8.8% reduction from baseline. Serum N-GAL increased by 34.1+/-16.7% following an overnight fast pre-operatively (day 0) (ΔNGAL 45.1+/-36.0ng/ml), by a further 14.9+/-7.2% following surgery (immediate post-op). The largest ΔNGAL was observed during the pre-operative fasting period. ΔNGAL [day -1 to day 0] and [day -1 to post-op] were found to correlate inversely with eGFR at 6 weeks (p<0.05, r2=0.47 and p<0.001, r2=0.52 respectively). We conclude that clinically significant AKI does occur in the donor following live donor nephrectomy. Optimisation of perioperative fluid management is likely to have a protective role.

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