Wang I-C, Hsu W-L, Wu P-H, Yin H-Y, Tsai H-J, Lee Y-J
Institute of Veterinary Clinical Science, School of Veterinary Medicine College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan.
Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan.
J Vet Intern Med. 2017 Jan;31(1):102-108. doi: 10.1111/jvim.14628. Epub 2016 Dec 25.
Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for the early prediction of renal damage and the progression of chronic kidney disease (CKD) in humans and dogs.
Neutrophil gelatinase-associated lipocalin also may play a role in the progression of CKD in cats.
Eighty CKD and 18 control cats.
Cats were categorized into different stages according to the International Renal Interest Society (IRIS) staging system. Urine and plasma samples were collected and tested for NGAL concentrations using an in-house sandwich ELISA system and urinary NGAL (uNGAL)-to-creatinine ratio (UNCR) was determined. Cats in which serum creatinine concentration increased by >0.5 mg/dL from baseline within 30 days were defined as exhibiting progression.
The urinary NGAL and UNCR of CKD cats were significantly higher than those of healthy cats (P < .05) and were highly correlated with serum creatinine concentration. The area under the receiver operating characteristic curve (AUROC) for uNGAL, when predicting the progression of CKD, was 0.71 and the best cutoff value was 2.06 ng/mL with a sensitivity of 76.9% and a specificity of 75%. The AUROC for UNCR when predicting the progression of CKD was 0.79 and the best cutoff value was 4.08 × 10 with a sensitivity of 76.9% and specificity of 79.2%. Cats with UNCR values higher than their cutoffs experienced significantly faster deterioration with a median of 19 days.
Both urinary NGAL and UNCR are useful markers for the prediction of CKD progression in cats.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是人类和犬类肾损伤及慢性肾脏病（CKD）进展早期预测的生物标志物。
中性粒细胞明胶酶相关脂质运载蛋白在猫CKD进展中也可能起作用。
80只患有CKD的猫和18只对照猫。
根据国际肾脏兴趣协会（IRIS）分期系统将猫分为不同阶段。收集尿液和血浆样本，使用内部夹心酶联免疫吸附测定系统检测NGAL浓度，并测定尿NGAL（uNGAL）与肌酐比值（UNCR）。血清肌酐浓度在30天内较基线升高>0.5mg/dL的猫被定义为病情进展。
CKD猫的尿NGAL和UNCR显著高于健康猫（P<.05），且与血清肌酐浓度高度相关。预测CKD进展时，uNGAL的受试者工作特征曲线下面积（AUROC）为0.71，最佳临界值为2.06ng/mL，灵敏度为76.9%，特异性为75%。预测CKD进展时，UNCR的AUROC为0.79，最佳临界值为4.08×10，灵敏度为76.9%，特异性为79.2%。UNCR值高于临界值的猫病情恶化明显更快，中位数为19天。
尿NGAL和UNCR都是预测猫CKD进展的有用标志物。
