Neutrophil gelatinase-associated lipocalin for early diagnosis of acute kidney injury in patients with acute decompensated heart failure

Abstract

Background: the incidence of acute kidney injury (AKI) is high in patients with acute decompensated heart failure (ADHF) and is linked with increased morbidity and mortality rates. Predictive biomarkers of AKI could allow improve outcomes in AKI. Purpose: to evaluate the value of serum neutrophil gelatinase‑associated lipocalin (NGAL) concentrations for early diagnosis of AKI in patients with ADHF with left ventricular (LV) systolic function. Methods: we enrolled 60 men (average age was 62.0±11.1 years) hospitalized with ADHF with reduced LV systolic function (LV ejection fraction (LVEF) <40%). AKI was defined according to KDIGO Clinical Practice Guidelines. We measured of serum NGAL (sNGAL) concentrations by a quantitative sandwich enzyme immunoassay technique (RD systems, DLCN20, USA) at admission. Results: sNGAL concentrations were significantly higher in patients with AKI 171.2 (159.0-241.2) ng/mL compared without AKI 136.8 (108.2-163.0) ng/mL P < 0.001. For predicting AKI, ROC analysis was performed. The area under curve (AUC) of sNGAL concentrations at admission was 0.83 (95% confidence interval [95% CI], 0.73 to 0.93; P<0.001). A cutoff of 157.35 ng/mL yielded sensitivity (0.83) and specificity (0.74). sNGAL concentrations > 157.35 ng/mL had 13.8‑fold increase in the odds of developing AKI (95% CI, 3.93 to 48.42). Conclusion: sNGAL can be used for early diagnosis of AKI in patients with ADHF with reduced LV systolic function.