Martino Francesca Katiana, Filippi Ilenia, Giavarina Davicle, Kaushik Manish, Rodighiero Maria Pia, Crepaldi Carlo, Teixeira Caterina, Nadal Asunciòn Ferrer, Rosner Mitchell H, Ronco Claudio
Contrib Nephrol. 2012;178:258-263. doi: 10.1159/000337888. Epub 2012 May 25.
Neutrophil gelatinase-associated lipocalin (NGAL), a protein involved in iron handling, has been recognized as a marker of inflammation. In this regard, serum and urine NGAL levels have proven a useful diagnostic tool for acute kidney injury. Bacterial peritonitis is an all too common complication of peritoneal dialysis (PD) and while diagnosis in most cases is routine, there are times when patients present with typical symptoms but do not have an elevated PD effluent white blood cell count. Furthermore, patients may present with an elevated PD fluid white count, a cloudy effluent and no evidence of active infection. In these cases, a discriminating role for peritoneal fluid NGAL would be useful to distinguish bacterial and nonbacterial PD fluid infection. A small case control study was performed which demonstrated a very high sensitivity and specificity for peritoneal fluid NGAL. These preliminary data show that peritoneal fluid NGAL may be a useful tool for the early and accurate diagnosis of peritonitis.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是一种参与铁代谢的蛋白质，已被公认为炎症标志物。在这方面，血清和尿液中的NGAL水平已被证明是诊断急性肾损伤的有用工具。细菌性腹膜炎是腹膜透析（PD）极为常见的并发症，虽然大多数情况下诊断是常规的，但有时患者表现出典型症状，但腹膜透析流出液白细胞计数并未升高。此外，患者可能出现腹膜透析液白细胞计数升高、流出液浑浊且无活动性感染迹象。在这些情况下，腹膜液NGAL的鉴别作用有助于区分细菌性和非细菌性腹膜透析液感染。进行了一项小型病例对照研究，结果表明腹膜液NGAL具有非常高的敏感性和特异性。这些初步数据表明，腹膜液NGAL可能是早期准确诊断腹膜炎的有用工具。
