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| Item Type: | Article |
|---|---|
| Title: | Urinary NGAL-positive acute kidney injury and poor long-term Ootcomes in hospitalized patients |
| Creators Name: | Singer, E., Schrezenmeier, E.V., Elger, A., Seelow, E.R., Krannich, A., Luft, F.C. and Schmidt-Ott, K.M. |
| Abstract: | Introduction: Neutrophil gelatinase-associated lipocalin (NGAL) is a widely studied biomarker of renal tubular injury. Urinary NGAL (uNGAL) during acute kidney injury (AKI) predicts short-term adverse outcomes. However, the long-term predictive value is unknown. Methods: We performed a prospective observational study of 145 patients with hospital-acquired AKI according to Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) criteria and analyzed the long-term predictive value of uNGAL at the time of AKI. We defined a composite outcome of all-cause mortality and the development of end-stage renal disease (ESRD). Results: In all, 61 AKI patients died and 22 developed ESRD within 6 months. The uNGAL levels were significantly higher in patients with poor long-term outcomes. uNGAL levels >=362 {mu}g/l (highest quartile) and uNGAL levels between 95 and 362 {mu}g/l (third quartile) were associated with hazard ratios of 3.7 (95% confidence interval, 2.1–6.5) and 1.9 (1.1–3.5), respectively, compared with uNGAL levels <95 {mu}g/l (lower quartiles). After 6 months, 67% and 43% of patients within the highest and third uNGAL quartile, respectively, had either progressed to ESRD or died, compared to only 21% of patients with uNGAL in the lower 2 quartiles (P < 0.001). In multivariable Cox regression analyses accounting for conventional predictors, uNGAL was the strongest independent predictor of adverse long-term outcomes. The association of uNGAL levels and poor long-term outcomes remained significant in the subgroup of 107 AKI survivors discharged without requiring dialysis (P = 0.002). Discussion: These data indicate that elevated uNGAL levels at AKI diagnosis predict poor long-term outcomes. |
| Keywords: | Acute Kidney Injury, Long-Term Outcomes, Neutrophil Gelatinase-Associated Lipocalin (NGAL) |
| Source: | Kidney International Reports |
| ISSN: | 2468-0249 |
| Publisher: | Elsevier |
| Volume: | 1 |
| Number: | 3 |
| Page Range: | 114-124 |
| Date: | September 2016 |
| Official Publication: | https://doi.org/10.1016/j.ekir.2016.07.003 |
| PubMed: | View item in PubMed |
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