SERUM NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AS A PREDICTIVE BIOMARKER OF KIDNEY INJURY IN RENAL TRANSPLANTED PATIENTS and CHRONIC KIDNEY DISEASE
DOI:
https://doi.org/10.22159/ijpps.2017v9i6.17510Keywords:
Neutrophil gelatinase-associated lipocalin, Kidney injury, Kidney transplant recipients, Chronic kidney diseaseAbstract
Objective: Neutrophil gelatinase-associated lipocalin has emerged as a promising biomarker of kidney injury better than creatinine to early predict the acute kidney injury in both chronic kidney diseases and early diagnosis of kidney allograft dysfunction.
Methods: Neutrophil gelatinase-associated lipocalin was evaluated as a new biomarker for acute renal injury in 69 patients were divided in two groups chronic kidney disease patients (stage5), (n=34), and renal transplant patients, (n=35) comparing with apparently healthy control (n= 35) of matching age and weight. Neutrophil gelatinase-associated lipocalin, hsCRP and Cystatin-C were measured by enzyme-linked immune sorbent assay which is included first incubating the test serum in an antigen-coated polystyrene plate, then enzyme labelled anti-immunoglobulin is added and the enzyme then remaining in plate after washing provides a measure of the amount of specific antibody in the serum and in the final step a substance is added that the enzyme can convert to some detectable signal, most commonly a color change in a chemical substrate.
Results: There was a significant increase in serum NGAL of renal transplantation patients, and CKD patients (stage5) than in healthy control subjects (455±145 ng/ml vs. 296.4±83.5 ng/ml 486±153 ng/ml vs296. 4±83.5 ng/ml) respectively. A high serum Neutrophil gelatinase-associated lipocalin is noted in renal transplanted patients after one month, then after six months (480±188ng/ml vs. 409±78ng/ml). There was a significant negative correlation between serum Neutrophil gelatinase-associated lipocalin in renal transplanted patients, and chronic kidney disease patients (stage 5) with an estimated glomerular filtration rate (p<0.05).
Conclusion: Serum neutrophil gelatinase-associated lipocalin seems to be an early predictor of kidney injury and post-transplantation management, including dialysis and grafting function of the kidney.
Downloads
References
Dasari P, konuru V, venisetty RK. Management of comorbidities in chronic kidney disease: a prospective observational study. Int J Pharm Pharm Sci 2014;6:363-7.
Devarajan Prasad. Neutrophil gelatinase-associated lipocalin: a promising biomarker for human acute kidney injury. Biomarkers Med 2010;4:265–80.
Mårtensson J, Martling CR, Bell MJ. Martensson novel biomarkers of acute kidney injury and failure: clinical applicability. Br J Anaesthesia 2012;109:843–50.
Gillespie A, Lee IJ. Biomarkers in renal transplantation. Biomark Med 2008;2:603–12.
Parikh CR, Moledina DG, Coca SG, Thiessen-Philbrook HR, Garg AX. Application of new acute kidney injury biomarkers in human randomized controlled trials. Kidney Int 2016;89:1372–9.
Malyszko J, Lukaszyk E, Glowinska I, Durlik M. Biomarkers of delayed graft function as a form of acute kidney injury in kidney transplantation. Sci Rep 2015;5:11684.
Xu SY, Carlson M, Engström A, Garcia R, Peterson CG, Venge P. Purification and characterization of a human neutrophil lipocalin (HNL) from the secondary granules of human neutrophils. Scand J Clin Lab Invest 1994;54:365–76.
Flower DR, North AC, Sansom CE. The lipocalin protein family: structural and sequence overview. Biochim Biophys Acta 2000;1482:9–24.
Mori K, Nakao K. Neutrophil gelatinase-associated lipocalin as the real-time indicator of active kidney damage. Kidney Int 2007;71:967-70.
Supavekin S, Zhang W, Kucherlapati R, Kaskel FJ, Moore LC, Devarajan Pet. Differential gene expression following early renal ischemia-reperfusion. Kidney Int 2003;63:1714–24.
Mishra J, Ma Q, Prada A, Zahedi K, Yang Y, Barasch J, et al. Identification of neutrophil gelatinase-associated lipocalin as a novel urinary biomarker for ischemic injuryâ€. J Am Soc Nephrol 2003;4:2534–43.
Siedlecki A, Irish W, Brennan DC. Delayed graft function in the kidney transplant. Am J Transplant 2011;11:2279-96.
Akkina SK, Connaire JJ, Israni AK, Snyder JJ, Matas AJ, Kasiske BL. Similar outcomes with different rates of delayed graft function may reflect center practice, not center performance. Am J Transplant 2009;9:1460–6.
Hollmen ME, Kyllönen LE, Inkinen KA, Lalla MLT, Merenmies J, Salmela KT. Deceased donor neutrophil gelatinase-associated lipocalin and delayed graft function after kidney transplantation: a prospective study. Crit Care 2011;15:R121.
Magnusson NE, Hornum M, Jørgensen KA, Hansen JM, Bistrup C, Feldt-Rasmussen B, et al. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is associated with kidney function in uremic patients before and after kidney transplantation. BMC Nephrol 2012;13:8.
Bataille A, Abbas S, Semoun O, Bourgeois É, Marie O, Bonnet F, et al. Plasma neutrophil gelatinase-associated lipocalin in kidney transplantation and early renal function prediction. Transplantation 2011;92:1024–30.
Haase-Fielitz A, Haase M, Devarajan P. Neutrophil gelatinase-associated lipocalin as a biomarker of acute kidney injury: a critical evaluation of current status. Ann Clin Biochem 2014;51:335–51.
Haase M, Haase-Fielitz A. Neutrophil gelatinase-associated lipocalin for acute kidney injury–the renal troponin? J Lab Med 2010;165:28–32.
DiSomma S, Magrini L, De Berardinis B, Marino R, Ferri E, Moscatelli P, et al. Additive value to clinical judgement of blood neutrophil gelatinase-associated lipocalin in diagnosis of acute kidney injury and prediction of mortality in patients hospitalized from the emergency department. Critical Care 2012;16:P354.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, et al. CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150:604-12.
World Health Organization WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894. Geneva; 2000.
Mishra J, Mori K, Ma Q, Kelly C. Neutrophil gelatinase-associated lipocalin: a novel early urinary biomarker for cisplatin nephrotoxicity. Am J Nephrol 2004;24:307-15.
Mishra J, Ma Q, Prada A. Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury. J Am Soc Nephrol 2003;14:2534-43.
Moise, B Serbænescu, C Gîngu, I Constantinescu. Neutrophil gelatinase-associated lipocalin (NGAL)–a potential biomarker for early diagnosis of acute rejection in renal transplantation. Rev Românæ Urol 2012;11:26-30.
Lebkowska U, Malyszko J, Lebkowska A. Neutrophil gelatinase-associated lipocalin and cystatin C could predict renal outcome in patients undergoing kidney allograft transplantation: a prospective study. Transplant Proc 2009;41:154–7.
Kavalci Cemil, Celikel Elif, Yilmaz Muhittin Serkan. The value of serum NGAL in the determination of dialysis indication 2014;64:739-42.
Parikh CR, Devrajan P. New biomarkers of acute kidney injury. Crit Care Med 2008;36:166-71.
Mahdavi-Mazdeh M, Amerian M, Abdollahi A, Hatmi ZN, Khatami MR. Comparison of serum neutrophil gelatinase-associated lipocalin (NGAL) with serum creatinine in the prediction of kidney recovery after renal transplantation. Int J Organ Transplant Med 2012;3:176–82.
Devarajan P. Neutrophil gelatinase-associated lipocalin (NGAL): a new marker of kidney disease. Scand J Clin Lab Invest Suppl 2008;241:89-94.
Ozkan S, Durukan P, Kavalci C, Duman A, Sayhan MB, Salt O, et al. Importance of neutrophil gelatinase-associated lipocalin in the differential diagnosis of acute and chronic renal failure. Iran Red Crescent Med J 2014;16:e14133.
Kümpers P, Hafer C, Lukasz A, Lichtinghagen R, Brand K, Fliser D, et al. Serum neutrophil gelatinase-associated lipocalin at the inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury. Crit Care 2010;14:R9.
Haase M, Devarajan P, Haase-Fielitz A, Bellomo R, Cruz DN, Wagener G, et al. The outcome of neutrophil gelatinase-associated lipocalin (NGAL)-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies. J Am Coll Cardiol 2011;57:1752–61.
Sanjeevani S, Pruthi S, Kalra S, Goel A, Kalra OP. Role of neutrophil gelatinase-associated lipocalin for early detection of acute kidney injury. Int J Crit Illness Injury Sci 2014;4:223–8.
Mori K, Lee HT, Rapoport D, Drexler IR, Foster K, Yang J, et al. Endocytic delivery of lipocalin-siderophore-iron complex rescues the kidney from ischemia-reperfusion injury. J Clin Invest 2005;115:610–21.
Nishida M, Kawakatsu H, Okumura Y, Hamaoka K. Serum and urinary neutrophil gelatinase-associated lipocalin levels in children with chronic renal diseases. Pediatr Int 2010;52:563-8.
Bolignano D, Lacquaniti A, Coppolino G, Donato V, Campo S, Fazio MR, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol 2009;4:337–44.
Esin Avci Çiçek, Simin Rota, Belda Dursun, Emine Kavalci. Evaluation of serum NGAL and hepcidin levels in chronic kidney disease patients. Ren Fail 2016;38:35-9.
Yarlagadda SG, Coca SG, Formica RN Jr, Poggio ED, Parikh CR. Association between delayed graft function and allograft and patient survival: a systematic review and meta-analysis. Nephrol Dial Transplant 2009;24:1039-47.
Bolignano D, Coppolino G, Romeo A, Lacquaniti A, Buemi M. Neutrophil gelatinase-associated lipocalin levels in chronic hemodialysis patients. Nephrology 2010;15:23–6.
Mitsnefes MM, Kathman TS, Mishra J, Kartal J, Khoury RP, Thomas L, et al. Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in children with chronic kidney disease. Pediatr Nephrol 2007;22:101-8.
Aghel A, Shrestha K, Mullens W, Borowski A, Tang WH. Serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting worsening renal function in acute decompensated heart failure. J Card Fail 2010;16:49-54.
Malyszko J, Bachorzewska-Gajewska H, Sitniewska E, Malyszko JS, Poniatowski B, Dobrzycki S. Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in non-diabetic patients with stage 2-4 chronic kidney disease. Ren Fail 2008;30:1-4.
Malyszko J, Malyszko JS, Koc-Zorawska E, Kozminski P, Mysliwiec M. Neutrophil gelatinase-associated lipocalin in dialyzed patients is related to residual renal function, type of renal replacement therapy and inflammation. Kidney Blood Press Res 2009;32:464–9.
Jolanta Malyszko J, Ewelina Lukaszyk, Irena Glowinska I, Magdalena Durlik M. Biomarkers of delayed graft function as a form of acute kidney injury in kidney transplantation. Scientific Reports 2015;5:11684.
Published
How to Cite
Issue
Section
