Yavuz Sevgi, Anarat Ali, Acartürk Sabri, Dalay Ahmet Cemil, Kesiktaş Erol, Yavuz Metin, Acartürk Tahsin Oğuz
Division of Pediatric Nephrology, Cukurova University School of Medicine, Adana, Turkey.
Division of Pediatric Nephrology, Cukurova University School of Medicine, Adana, Turkey.
Burns. 2014 Jun;40(4):648-54. doi: 10.1016/j.burns.2013.09.004. Epub 2013 Sep 21.
Neutrophil gelatinase associated lipocalin (NGAL) is a novel predictor of acute kidney injury (AKI), which increases with inflammation. We aimed to assess whether serum NGAL (SNGAL) and urine NGAL (UNGAL) can predict AKI in burned children.
Patients were referred within the 12 h of burn to our center. Serum samples for SNGAL, C-reactive protein (CRP), procalcitonin (PCT) and urine for UNGAL, microalbumine (Umalb), creatinine (Ucr) were obtained at both admission and the 5th day after burn. Blood urea nitrogen (BUN) and serum creatinine (Scr) were examined daily.
Twenty-two subjects were enrolled and six (27.2%) of them developed AKI within the 48 h of injury. Burn size and abbreviated burn severity index (ABSI) were significantly increased in patients with AKI. CRP, PCT, SNGAL and UNGAL levels at admission and day 5 were significantly higher in patients with AKI than in those without AKI and controls. Scr was not significant between AKI and non-AKI groups at hospital days 1 and 5. A SNGAL level of 315 ng/ml and a UNGAL level of 100 ng/ml were determined as predictive cut-off values of AKI at admission (sensitivity and specificity: 71.4%, 83.3% and 93.3%, 93.7%, respectively). SNGAL and UNGAL were positively correlated with CRP, PCT, ABSI and Umalb/Ucr.
SNGAL and UNGAL are good early predictors of AKI in children with severe burn. NGAL might reflect the severity of burn insult and also could be used as an indicator of inflammation in burn children.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是急性肾损伤（AKI）的一种新型预测指标，其水平会随炎症反应而升高。我们旨在评估血清NGAL（SNGAL）和尿NGAL（UNGAL）能否预测烧伤儿童的AKI。
患者在烧伤后12小时内被转诊至我们中心。在入院时及烧伤后第5天采集血清样本检测SNGAL、C反应蛋白（CRP）、降钙素原（PCT），采集尿液样本检测UNGAL、微量白蛋白（Umalb）、肌酐（Ucr）。每日检测血尿素氮（BUN）和血清肌酐（Scr）。
共纳入22名受试者，其中6名（27.2%）在受伤后48小时内发生AKI。发生AKI的患者烧伤面积和简化烧伤严重程度指数（ABSI）显著增加。AKI患者入院时及第5天的CRP、PCT、SNGAL和UNGAL水平显著高于未发生AKI的患者及对照组。在住院第1天和第5天，AKI组和非AKI组的Scr无显著差异。确定入院时SNGAL水平为315 ng/ml、UNGAL水平为100 ng/ml作为AKI的预测临界值（敏感性和特异性分别为：71.4%、83.3%和93.3%、93.7%）。SNGAL和UNGAL与CRP、PCT、ABSI及Umalb/Ucr呈正相关。
SNGAL和UNGAL是重度烧伤儿童AKI的良好早期预测指标。NGAL可能反映烧伤损伤的严重程度，也可作为烧伤儿童炎症的指标。
