Skip to main content
SpringerLink
Log in

NGAL in Acute Kidney Injury

  • Chapter
Annual Update in Intensive Care and Emergency Medicine 2013

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

  • 2716 Accesses

Abstract

Acute kidney injury (AKI) represents an abrupt deterioration in kidney function and is a frequently encountered phenomenon in hospitalized patients [1, 2]. The impact of AKI is most profound among patients admitted to intensive care units (ICU). The incidence of AKI among hospitalized and critically ill patients appears to be increasing. This is likely attributable to demographic transition (i. e., older patients; more comorbid illness; greater prevalence of chronic kidney disease) coupled with admissions associated with increasingly complex medical and/or surgical diseases and the need for multi-faceted diagnostic and therapeutic interventions. The development of AKI now complicates the course in an estimated two-thirds of critically ill patients [3–5]. For those with more severe forms of AKI, an estimated 50–70 % will require support with acute renal replacement therapy (RRT), which represents a small, but important subgroup of all critically ill patients (4–8 %) [6]. The initiation of RRT can contribute to a considerable escalation in both the complexity of illness and associated costs of care. Indeed, these critically ill patients experience substantial morbidity, including non-recovery of kidney function and long-term chronic kidney disease or dialysis dependence [7– 9] as well as excess mortality, with hospital mortality rates commonly exceeding 60 % [6, 8].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW (2005) Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 16:3365–3370

    Article  PubMed  Google Scholar 

  2. Liangos O, Wald R, O’Bell JW, Price L, Pereira BJ, Jaber BL (2006) Epidemiology and outcomes of acute renal failure in hospitalized patients: a national survey. Clin J Am Soc Nephrol 1:43–51

    Article  PubMed  Google Scholar 

  3. Bagshaw SM, George C, Bellomo R (2007) Changes in the incidence and outcome for early acute kidney injury in a cohort of Australian intensive care units. Crit Care 11:R68

    Article  PubMed  Google Scholar 

  4. Bagshaw SM, George C, Dinu I, Bellomo R (2008) A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant 23:1203–1210

    Article  PubMed  Google Scholar 

  5. Hoste EA, Clermont G, Kersten A et al (2006) RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 10:R73

    Article  PubMed  Google Scholar 

  6. Uchino S, Kellum JA, Bellomo R et al (2005) Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 294:813–818

    Article  PubMed  CAS  Google Scholar 

  7. Ahlstrom A, Tallgren M, Peltonen S, Rasanen P, Pettila V (2005) Survival and quality of life of patients requiring acute renal replacement therapy. Intensive Care Med 31:1222–1228

    Article  PubMed  Google Scholar 

  8. Bagshaw SM, Laupland KB, Doig CJ et al (2005) Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study. Crit Care 9:R700–R709

    Article  PubMed  Google Scholar 

  9. Wald R, Quinn RR, Luo J et al (2009) Chronic dialysis and death among survivors of acute kidney injury requiring dialysis. JAMA 302:1179–1185

    Article  PubMed  CAS  Google Scholar 

  10. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P (2004) Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8:R204–212

    Article  PubMed  Google Scholar 

  11. Kidney Disease: Improving Global Outcomes (2012) KDIGO Clinical Practice Guidelines for Acute Kidney Injury. Kidney Int (Suppl 2):1–138

    Google Scholar 

  12. Haase-Fielitz A, Bellomo R, Devarajan P et al (2009) Novel and conventional serum biomarkers predicting acute kidney injury in adult cardiac surgery – a prospective cohort study. Crit Care Med 37:553–560

    Article  PubMed  CAS  Google Scholar 

  13. Cowland JB, Borregaard N (1997) Molecular characterization and pattern of tissue expression of the gene for neutrophil gelatinase-associated lipocalin from humans. Genomics 45:17–23

    Article  PubMed  CAS  Google Scholar 

  14. Devarajan P (2008) NGAL in acute kidney injury: from serendipity to utility. Am J Kidney Dis 52:395–399

    Article  PubMed  Google Scholar 

  15. Bolignano D, Coppolino G, Campo S et al (2008) Urinary neutrophil gelatinase-associated lipocalin (NGAL) is associated with severity of renal disease in proteinuric patients. Nephrol Dial Transplant 23:414–416

    Article  PubMed  CAS  Google Scholar 

  16. Bolignano D, Donato V, Coppolino G et al (2008) Neutrophil gelatinase-associated lipocalin (NGAL) as a marker of kidney damage. Am J Kidney Dis 52:595–605

    Article  PubMed  CAS  Google Scholar 

  17. Dent CL, Ma Q, Dastrala S et al (2007) Plasma neutrophil gelatinase-associated lipocalin predicts acute kidney injury, morbidity and mortality after pediatric cardiac surgery: a prospective uncontrolled cohort study. Crit Care 11:R127

    Article  PubMed  Google Scholar 

  18. Mishra J, Dent C, Tarabishi R et al (2005) Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 365:1231–1238

    Article  PubMed  CAS  Google Scholar 

  19. Cruz DN, de Cal M, Garzotto F et al (2010) Plasma neutrophil gelatinase-associated lipocalin is an early biomarker for acute kidney injury in an adult ICU population. Intensive Care Med 36:444–451

    Article  PubMed  CAS  Google Scholar 

  20. de Geus HR, Bakker J, Lesaffre EM, le Noble JL (2011) Neutrophil gelatinase-associated lipocalin at ICU admission predicts for acute kidney injury in adult patients. Am J Respir Crit Care Med 183:907–914

    Article  PubMed  Google Scholar 

  21. Endre ZH, Pickering JW, Walker RJ et al (2011) Improved performance of urinary biomarkers of acute kidney injury in the critically ill by stratification for injury duration and baseline renal function. Kidney Int 79:1119–1130

    Article  PubMed  CAS  Google Scholar 

  22. Shapiro NI, Trzeciak S, Hollander JE et al (2010) The diagnostic accuracy of plasma neutrophil gelatinase-associated lipocalin in the prediction of acute kidney injury in emergency department patients with suspected sepsis. Ann Emerg Med 56:52–59

    Article  PubMed  Google Scholar 

  23. Soni SS, Ronco C, Katz N, Cruz DN (2009) Early diagnosis of acute kidney injury: the promise of novel biomarkers. Blood Purif 28:165–174

    Article  PubMed  CAS  Google Scholar 

  24. de Geus HR, Woo JG, Wang Y et al (2011) Urinary neutrophil gelatinase-associated lipocalin measured on admission to the intensive care unit accurately discriminates between sustained and transient acute kidney injury in adult critically ill patients. Nephron Extra 1:9–23

    Article  PubMed  Google Scholar 

  25. Haase M, Devarajan P, Haase-Fielitz A et al (2011) The outcome of neutrophil gelatinase-associated lipocalin-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies. J Am Coll Cardiol 57:1752–1761

    Article  PubMed  CAS  Google Scholar 

  26. Ronco C, Stacul F, McCullough PA (2013) Subclinical acute kidney injury (AKI) due to iodine-based contrast media. Eur Radiol 23:319–323

    Google Scholar 

  27. Ronco C, Kellum JA, Haase M (2012) Subclinical AKI is still AKI. Crit Care 16:313

    Article  PubMed  Google Scholar 

  28. Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A (2009) Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis 54:1012–1024

    Article  PubMed  CAS  Google Scholar 

  29. Nickolas TL, O’Rourke MJ, Yang J et al (2008) Sensitivity and specificity of a single emergency department measurement of urinary neutrophil gelatinase-associated lipocalin for diagnosing acute kidney injury. Ann Intern Med 148:810–819

    PubMed  Google Scholar 

  30. Doi K, Negishi K, Ishizu T et al (2011) Evaluation of new acute kidney injury biomarkers in a mixed intensive care unit. Crit Care Med 39:2464–2469

    Article  PubMed  CAS  Google Scholar 

  31. Kumpers P, Hafer C, Lukasz A et al (2010) Serum neutrophil gelatinase-associated lipocalin at inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury. Crit Care 14:R9

    Article  PubMed  Google Scholar 

  32. Koyner JL, Garg AX, Coca SG et al (2012) Biomarkers predict progression of acute kidney injury after cardiac surgery. J Am Soc Nephrol 23:905–914

    Article  PubMed  CAS  Google Scholar 

  33. Srisawat N, Murugan R, Lee M et al (2011) Plasma neutrophil gelatinase-associated lipocalin predicts recovery from acute kidney injury following community-acquired pneumonia. Kidney Int 80:545–552

    Article  PubMed  CAS  Google Scholar 

  34. Srisawat N, Wen X, Lee M et al (2011) Urinary biomarkers and renal recovery in critically ill patients with renal support. Clin J Am Soc Nephrol 6:1815–1823

    Article  PubMed  CAS  Google Scholar 

  35. Parikh CR, Coca SG, Thiessen-Philbrook H et al (2011) Postoperative biomarkers predict acute kidney injury and poor outcomes after adult cardiac surgery. J Am Soc Nephrol 22:1748–1757

    Article  PubMed  CAS  Google Scholar 

  36. Koyner JL, Vaidya VS, Bennett MR et al (2010) Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury. Clin J Am Soc Nephrol 5:2154–2165

    Article  PubMed  CAS  Google Scholar 

  37. Liangos O, Perianayagam MC, Vaidya VS et al (2007) Urinary N-acetyl-beta-(D)-glucosaminidase activity and kidney injury molecule-1 level are associated with adverse outcomes in acute renal failure. J Am Soc Nephrol 18:904–912

    Article  PubMed  CAS  Google Scholar 

  38. Wagener G, Gubitosa G, Wang S, Borregaard N, Kim M, Lee HT (2008) Urinary neutrophil gelatinase-associated lipocalin and acute kidney injury after cardiac surgery. Am J Kidney Dis 52:425–433

    Article  PubMed  CAS  Google Scholar 

  39. Torregrosa I, Montoliu C, Urios A et al (2012) Early biomarkers of acute kidney failure after heart angiography or heart surgery in patients with acute coronary syndrome or acute heart failure. Nefrologia 32:44–52

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada

    O. Rewa

  2. Division of Critical Care Medicine, Faculty of Medicine and Dentistry, 3C1.12 Walter C. Mackenzie Center, University of Alberta, 8440 - 112 Street NW, T6G 2B7, Edmonton, Canada

    S. M. Bagshaw

Authors
  1. O. Rewa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. M. Bagshaw
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. M. Bagshaw .

Editor information

Editors and Affiliations

  1. Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent Prof.

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Rewa, O., Bagshaw, S.M. (2013). NGAL in Acute Kidney Injury. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2013. Annual Update in Intensive Care and Emergency Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35109-9_55

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-35109-9_55

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35108-2

  • Online ISBN: 978-3-642-35109-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation