Jahaj Edison, Vassiliou Alice G, Pratikaki Maria, Gallos Parisis, Mastora Zafeiria, Dimopoulou Ioanna, Orfanos Stylianos E, Orfanos Philippos, Lagiou Pagona, Kotanidou Anastasia
First Department of Critical Care Medicine & Pulmonary Services, School of Medicine, National & Kapodistrian University of Athens, Evangelismos Hospital, 10676 Athens, Greece.
Department of Biochemistry, Evangelismos Hospital, 10676 Athens, Greece.
J Clin Med. 2021 Nov 18;10(22):5379. doi: 10.3390/jcm10225379.
Acute kidney injury (AKI) is one of the most common complications in critically ill patients. In recent years, studies have focused on exploring new biomarkers for the early diagnosis and prognosis of AKI. The aim of this study was to investigate serum prognostic biomarkers (neutrophil gelatinase-associated lipocalin, NGAL, and creatinine) of AKI in critically ill patients. The study included 266 critically ill, initially nonseptic, patients admitted to a multidisciplinary ICU. Serum levels of NGAL and creatinine were measured at ICU admission. ROC curves were generated to estimate the prognostic value of the biomarkers, while a logistic regression analysis was performed to assess their association with an increased AKI risk. Patients were divided in two groups based on the development ( = 98) or not ( = 168) of AKI during their ICU stay. Serum NGAL levels at ICU admission were significantly higher in those who subsequently developed AKI compared to those who did not ( < 0.0001). NGAL was shown to be more accurate in predicting AKI development than creatinine; furthermore, NGAL levels were associated with an increased risk of AKI development (1.005 (1.002-1.008), < 0.0001). In the present study, we were able to demonstrate that increased serum NGAL levels at ICU admission might be predictive of AKI development during ICU hospitalization. Further studies are needed to support NGAL as a prognostic marker of acute kidney injury.
急性肾损伤（AKI）是重症患者最常见的并发症之一。近年来，研究集中于探索用于AKI早期诊断和预后评估的新生物标志物。本研究旨在调查重症患者中AKI的血清预后生物标志物（中性粒细胞明胶酶相关脂质运载蛋白，即NGAL，以及肌酐）。该研究纳入了266名入住多学科重症监护病房（ICU）的重症患者，这些患者最初并非脓毒症患者。在患者入住ICU时测量其血清NGAL和肌酐水平。绘制ROC曲线以评估这些生物标志物的预后价值，同时进行逻辑回归分析以评估它们与AKI风险增加之间的关联。根据患者在ICU住院期间是否发生AKI（发生AKI的患者n = 98，未发生AKI的患者n = 168）将其分为两组。随后发生AKI的患者在入住ICU时的血清NGAL水平显著高于未发生AKI的患者（P < 0.0001）。结果显示，NGAL在预测AKI发生方面比肌酐更准确；此外，NGAL水平与AKI发生风险增加相关（比值比为1.005（1.002 - 1.008），P < 0.0001）。在本研究中，我们能够证明入住ICU时血清NGAL水平升高可能预示着ICU住院期间AKI的发生。需要进一步的研究来支持将NGAL作为急性肾损伤的预后标志物。
