尿中性粒细胞明胶酶相关载脂蛋白：急性肾损伤不良结局的独立预测因子。
Urine neutrophil gelatinase-associated lipocalin: an independent predictor of adverse outcomes in acute kidney injury.
机构信息
Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
出版信息
Am J Nephrol. 2010;31(6):501-9. doi: 10.1159/000309841. Epub 2010 May 4.
BACKGROUND
Several recent studies have shown that neutrophil gelatinase-associated lipocalin (NGAL) may be a promising biomarker for the early detection of acute kidney injury (AKI), but the role of NGAL in predicting adverse clinical outcomes has not been well addressed. The purpose of this study was to evaluate the usefulness of urine NGAL as outcome predictor in patients with AKI.
METHODS
This was a prospective cohort study enrolling hospitalized AKI patients. Patients were divided into four groups according to initial urine NGAL excretion quartiles. The primary clinical outcome variables were in-hospital mortality and renal function at 4 weeks.
RESULTS
Initial urine NGAL was identified as an independent predictor of in-hospital mortality and persistent loss of renal function. In the analysis of predictive performance of urine NGAL, the AUC was 0.882 and a cutoff value of 298.28 ng/ml predicted loss of renal function with 88.2% sensitivity and 81.0% specificity.
CONCLUSION
This study could suggest that urine NGAL, a new early biomarker might also be served as a reliable clinical outcome predictor in AKI patients.
背景
最近的几项研究表明，中性粒细胞明胶酶相关脂质运载蛋白（NGAL）可能是急性肾损伤（AKI）早期检测的有前途的生物标志物，但 NGAL 在预测不良临床结局中的作用尚未得到很好的解决。本研究旨在评估尿 NGAL 作为 AKI 患者预后预测因子的作用。
方法
这是一项前瞻性队列研究，纳入住院 AKI 患者。患者根据初始尿 NGAL 排泄四分位值分为四组。主要临床结局变量为住院期间死亡率和 4 周时肾功能。
结果
初始尿 NGAL 是住院死亡率和肾功能持续丧失的独立预测因子。在尿 NGAL 预测性能分析中，AUC 为 0.882，截断值为 298.28ng/ml，预测肾功能丧失的灵敏度为 88.2%，特异性为 81.0%。
结论
本研究表明，尿 NGAL 作为一种新的早期生物标志物，也可能成为 AKI 患者可靠的临床结局预测因子。
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