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重症监护最初48小时内的中性粒细胞明胶酶相关脂质运载蛋白水平可能预示即将发生的急性肾损伤。

Neutrophil gelatinase-associated lipocalin levels during the first 48 hours of intensive care may indicate upcoming acute kidney injury.

作者信息

Kamis Fatih, Yegenaga Itir, Musul Mert, Baydemir Canan, Bek Sibel, Kalender Betül, Baykara Nur

机构信息

Department of Internal Medicine, Kocaeli University Medical School, University Hospital, Umuttepe Campus, Uctepeler, Kocaeli, Turkey.

Department of Biochemistry, Kocaeli University Medical School, University Hospital, Umuttepe Campus, Uctepeler, Kocaeli, Turkey.

出版信息

J Crit Care. 2016 Aug;34:89-94. doi: 10.1016/j.jcrc.2016.04.012. Epub 2016 Apr 21.

DOI:10.1016/j.jcrc.2016.04.012

PMID:27288617

Abstract

PURPOSE

The recognition of acute kidney injury (AKI) as early as possible is important in the intensive care unit. This study proposes that serum and urine levels of neutrophil gelatinase-associated lipocalin (NGAL) may be used for this purpose.

METHODS

One hundred and seven critically ill adult patients with no previous renal failure were included. NGAL levels were measured during the first 48 hours after admission; NGAL levels were followed for 7 days and classified based on Risk, Injury, Failure, Loss, and End-Stage Renal Failure criteria.

RESULTS

The AKI incidence was 35.5%, and serum NGAL (sNGAL) and urinary NGAL (uNGAL) levels were higher in the AKI group. The area under the receiver operating characteristic curve was 0.76 (P<.001) for sNGAL and 0.75 (P<.001) for uNGAL. Seventy-one percent of AKI cases were observed within 48 hours, with 11 additional cases in the ensuing 7 days. The mean serum creatinine levels in the 11 patients were not different from non-AKI levels (P=.197), but the NGAL values were different, and the area under the receiver operating characteristic curve for sNGAL uNGAL was 1.00 (P=.014) and 0.93 (P=.02), respectively.

CONCLUSIONS

Most AKI cases were diagnosed within the first 48 hours after admission, and NGAL was useful for predicting upcoming AKI.

摘要

目的

在重症监护病房尽早识别急性肾损伤（AKI）很重要。本研究提出，中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的血清和尿液水平可用于此目的。

方法

纳入107例既往无肾衰竭的成年危重症患者。在入院后的头48小时内测量NGAL水平；对NGAL水平进行7天的跟踪，并根据风险、损伤、衰竭、丧失和终末期肾衰竭标准进行分类。

结果

AKI发生率为35.5%，AKI组的血清NGAL（sNGAL）和尿液NGAL（uNGAL）水平更高。sNGAL的受试者工作特征曲线下面积为0.76（P<0.001），uNGAL为0.75（P<0.001）。71%的AKI病例在48小时内被观察到，在随后的7天内又有11例。11例患者的平均血清肌酐水平与非AKI水平无差异（P = 0.197），但NGAL值不同，sNGAL和uNGAL的受试者工作特征曲线下面积分别为1.00（P = 0.014）和0.93（P = 0.02）。