[Analysis of neutrophil gelatinase-associated lipocalin in the critical patient]

Abstract

Objective: To determine if NGAL value exceeding 150 ng/mL is a good diagnostic test for acute renal failure in critically ill patients.

Design: Prospective, observational cohort.

Setting: Intensive Care Unit and Cardiac Surgery Intensive Care Service at Hospital Germans Trias I Pujol.

Participants: Patients admitted to the Intensive Care department the Designated days in the studio.

Interventions: Analysis of serum creatinine blood given from 7 days prior to the start of the study, and daily during 4 weeks and by determination of NGAL urine test in frozen sample, analyzer ARCHITECT (Abbott Diagnostics) determined by immunoassay the day baseline and 2 times a week for 4 weeks, analysis of the stay and mortality.

Results: A total of 529 NGAL samples were obtained from 46 patients. 37% of patients had a value of NGAL>150 ng/mL. The Sensivity of the test to diagnose acute renal failure was 69%, Specifity was 75,7%. However, the Positive Predictive Test Value was 53%, which means that 47% of patients with high NGAL did not develop AKI. A NGAL >150 mg/dL was associated with a significantly higher SOFA and a longer stay in the ICU. The mortality of patients with elevated NGAL was 58.8%.

Conclusions: A NGAL>150 ng/mL does not seem to be an excellent test for AKI in critically ill patients but is associated with a worse prognosis.

Keywords: Acute renal failure; Critical illness; Fracaso renal agudo; Lipocalina asociada a la gelatinasa de neutrófilos; NGAL; Neutrophil gelatinase-associated lipocalin protein; Paciente crítico.