Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2015 Feb;65(2):267-74.
doi: 10.1053/j.ajkd.2014.07.025. Epub 2014 Oct 11.

Urine neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease and death in CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study

Kathleen D Liu  1 , Wei Yang  2 , Alan S Go  3 , Amanda H Anderson  2 , Harold I Feldman  2 , Michael J Fischer  4 , Jiang He  5 , Radhakrishna R Kallem  2 , John W Kusek  6 , Stephen R Master  7 , Edgar R Miller 3rd  8 , Sylvia E Rosas  9 , Susan Steigerwalt  10 , Kaixiang Tao  2 , Matthew R Weir  11 , Chi-Yuan Hsu  12 ; CRIC Study Investigators
Collaborators, Affiliations
Observational Study

Urine neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease and death in CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study

Kathleen D Liu et al. Am J Kidney Dis. 2015 Feb.

Abstract

Background: Chronic kidney disease is common and is associated with increased cardiovascular disease risk. Currently, markers of renal tubular injury are not used routinely to describe kidney health and little is known about the risk of cardiovascular events and death associated with these biomarkers independent of glomerular filtration-based markers (such as serum creatinine or albuminuria).

Study design: Cohort study, CRIC (Chronic Renal Insufficiency Cohort) Study.

Setting & participants: 3,386 participants with estimated glomerular filtration rate of 20 to 70mL/min/1.73m(2) enrolled from June 2003 through August 2008.

Predictor: Urine neutrophil gelatinase-associated lipocalin (NGAL) concentration.

Outcomes: Adjudicated heart failure event, ischemic atherosclerotic event (myocardial infarction, ischemic stroke, or peripheral artery disease), and death through March 2011.

Measurements: Urine NGAL measured at baseline with a 2-step assay using chemiluminescent microparticle immunoassay technology on an ARCHITECT i2000SR (Abbott Laboratories).

Results: There were 428 heart failure events (during 16,383 person-years of follow-up), 361 ischemic atherosclerotic events (during 16,584 person-years of follow-up), and 522 deaths (during 18,214 person-years of follow-up). In Cox regression models adjusted for estimated glomerular filtration rate, albuminuria, demographics, traditional cardiovascular disease risk factors, and cardiac medications, higher urine NGAL levels remained associated independently with ischemic atherosclerotic events (adjusted HR for the highest [>49.5ng/mL] vs lowest [≤6.9ng/mL] quintile, 1.83 [95% CI, 1.20-2.81]; HR per 0.1-unit increase in log urine NGAL, 1.012 [95% CI, 1.001-1.023]), but not heart failure events or deaths.

Limitations: Urine NGAL was measured only once.

Conclusions: Among patients with chronic kidney disease, urine levels of NGAL, a marker of renal tubular injury, were associated independently with future ischemic atherosclerotic events, but not with heart failure events or deaths.

Keywords: Chronic Renal Insufficiency Cohort (CRIC) Study; Neutrophil gelatinase-associated lipocalin (NGAL); biomarker; cardiovascular disease; chronic kidney disease (CKD); ischemic atherosclerotic event; renal tubular dysfunction; renal tubular injury.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Risk of adverse outcomes and levels of urine neutrophil gelatinase-associated lipocalin (NGAL) a. Kaplan-Meier curves showing risk of heart failure event by baseline urine NGAL quintiles (ng/ml) b. Kaplan-Meier curves showing risk of ischemic atherosclerotic event by baseline urine NGAL quintiles (ng/ml) c. Kaplan-Meier curves showing risk of death by baseline urine NGAL quintiles (ng/ml)
Figure 1
Figure 1
Risk of adverse outcomes and levels of urine neutrophil gelatinase-associated lipocalin (NGAL) a. Kaplan-Meier curves showing risk of heart failure event by baseline urine NGAL quintiles (ng/ml) b. Kaplan-Meier curves showing risk of ischemic atherosclerotic event by baseline urine NGAL quintiles (ng/ml) c. Kaplan-Meier curves showing risk of death by baseline urine NGAL quintiles (ng/ml)
Figure 1
Figure 1
Risk of adverse outcomes and levels of urine neutrophil gelatinase-associated lipocalin (NGAL) a. Kaplan-Meier curves showing risk of heart failure event by baseline urine NGAL quintiles (ng/ml) b. Kaplan-Meier curves showing risk of ischemic atherosclerotic event by baseline urine NGAL quintiles (ng/ml) c. Kaplan-Meier curves showing risk of death by baseline urine NGAL quintiles (ng/ml)
See this image and copyright information in PMC

References

    1. Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007 Nov 7;298(17):2038–2047. - PubMed
    1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N. Engl. J. Med. 2004 Sep 23;351(13):1296–1305. - PubMed
    1. Hemmelgarn BR, Manns BJ, Lloyd A, et al. Relation between kidney function, proteinuria, and adverse outcomes. JAMA. 2010 Feb 3;303(5):423–429. 2010. - PubMed
    1. Matsushita K, van der Velde M, Astor BC, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010 Jun 12;375(9731):2073–2081. - PMC - PubMed
    1. Israni AK, Kasiske BL. Laboratory assessment of kidney disease: glomerular filtration rate, urinalysis, and proteinuria. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, editors. Brenner and Rector’s The Kidney. 9th ed. Elsevier Saunders; Philadelphia: 2012. pp. 868–869.

Publication types

MeSH terms

Grants and funding