Department of Nephrology and Transplantology, Medical University of Bialystok, Poland.
Arch Med Sci. 2011 Aug;7(4):658-64. doi: 10.5114/aoms.2011.24136. Epub 2011 Sep 2.
Neutrophil gelatinase-associated lipocalin (NGAL) has been recently proved useful in the quantitation of chronic kidney disease (CKD). The aim of the study was to assess prevalence of CKD according to the Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulae in 412 patients with normal serum creatinine and markers of kidney function/injury such as NGAL, cystatin C, and kidney injury molecule-1 (KIM-1) in these patients in relation to age (below and over 65 years).
We included in the study 1005 patients with coronary artery disease and normal serum creatinine. However, markers of kidney function/injury were assessed in 412 patients. The NGAL, cystatin C and KIM-1, were assessed using commercially available kits.
Patients over 65 years had significantly lower estimated glomerular filtration rate (eGFR) than their younger counterparts despite identical creatinine. They also had significantly lower haematocrit, despite similar Hb, lower platelet count, higher serum fibrinogen, higher systolic (SBP) and lower diastolic blood pressure, higher serum NGAL and cystatin C, but similar urinary NGAL and KIM-1. Serum NGAL correlated with age, haematocrit, leukocyte, platelet and erythrocyte count, eGFR, creatinine, fasting glucose, HbA(1c), fibrinogen, SBP, and diabetes duration. In multiple regression analysis kidney function (eGFR, creatinine clearance or creatinine), cystatin C and SBP were predictors of serum NGAL.
In our study we found a very high prevalence of CKD up to 61% in elderly patients with coronary artery disease and normal serum creatinine. Neutrophil gelatinase-associated lipocalin could be a sensitive marker of kidney function, particularly in elderly patients with another risk factor for kidney damage, i.e. hypertension.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）最近已被证明可用于定量慢性肾脏病（CKD）。本研究的目的是评估 412 例血清肌酐正常且肾功能/损伤标志物（如 NGAL、胱抑素 C 和肾损伤分子-1（KIM-1））正常的患者中，根据改良肾脏病饮食研究（MDRD）、 Cockcroft-Gault 和慢性肾脏病流行病学协作组（CKD-EPI）公式计算的 CKD 患病率，这些患者按年龄（<65 岁和>65 岁）分组。
我们纳入了 1005 例患有冠心病且血清肌酐正常的患者。然而，在 412 例患者中评估了肾功能/损伤标志物。使用商业试剂盒评估 NGAL、胱抑素 C 和 KIM-1。
尽管血清肌酐相同，但>65 岁的患者估算肾小球滤过率（eGFR）显著低于年轻患者。他们的血细胞比容、血红蛋白、血小板计数、血清纤维蛋白原、收缩压（SBP）和舒张压也明显较低，血清 NGAL 和胱抑素 C 更高，但尿液 NGAL 和 KIM-1 相似。血清 NGAL 与年龄、血细胞比容、白细胞、血小板和红细胞计数、eGFR、肌酐、空腹血糖、HbA（1c）、纤维蛋白原、SBP 和糖尿病病程相关。在多元回归分析中，肾功能（eGFR、肌酐清除率或肌酐）、胱抑素 C 和 SBP 是血清 NGAL 的预测因子。
在我们的研究中，我们发现患有冠心病且血清肌酐正常的老年患者中 CKD 的患病率非常高，高达 61%。中性粒细胞明胶酶相关脂质运载蛋白可能是肾功能的敏感标志物，尤其是在患有另一种肾脏损伤危险因素（即高血压）的老年患者中。
