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Sepsis and AKI in Clinical Emergency Room Patients: The Role of Urinary NGAL.

Nga HS, Medeiros P, Menezes P, Bridi R, Balbi A, Ponce D - Biomed Res Int (2015)

Bottom Line: The uNGAL1 and uNGAL2, as well as uNGAL1/uCr1 and uNGAL2/uCr2, were good predictors for AKI (AUC-ROC 0.73, 0.70, 0.77, and 0.84, resp.).The uNGAL1 and uNGAL1/uCr1 were poor predictors for death (AUC-ROC 0.66 and 0.68, resp.), whereas uNGAL2 and uNGAL2/uCr2 were better predictors (AUC-ROC 0.70 and 0.81, resp.).The uNGAL is highly sensitive but nonspecific predictor of AKI and death in septic patients admitted into ER.

View Article: PubMed Central - PubMed

Affiliation: São Paulo State University (UNESP), Distrito de Rubião Junior, s/n, 18618-970 Botucatu, SP, Brazil.

ABSTRACT

Background: Few studies have investigated the predictive properties of urinary (u) NGAL as an AKI marker in septic population.

Objectives: This study evaluated the efficacy of uNGAL as predictor of AKI and death in septic patients admitted to the clinical emergency room (ER).

Methodology: We prospectively studied patients with sepsis admitted to the ER. Urine was analyzed for NGAL within the first 24 hours after admission (classified as NGAL1), between 24 and 48 h (NGAL2), and at moment of AKI diagnosis (NGAL3).

Results: Among 168 septic patients admitted to ER, 72% developed AKI. The uNGAL and its relationship with creatinine (Cr) were high in septic patients but statistically higher in those with sepsis and AKI. The uNGAL1 and uNGAL2, as well as uNGAL1/uCr1 and uNGAL2/uCr2, were good predictors for AKI (AUC-ROC 0.73, 0.70, 0.77, and 0.84, resp.). The uNGAL1 and uNGAL1/uCr1 were poor predictors for death (AUC-ROC 0.66 and 0.68, resp.), whereas uNGAL2 and uNGAL2/uCr2 were better predictors (AUC-ROC 0.70 and 0.81, resp.).

Conclusion: The uNGAL is highly sensitive but nonspecific predictor of AKI and death in septic patients admitted into ER.

No MeSH data available.


Related in: MedlinePlus

ROC analysis of uNGAL measure on day 1 of admission to the ER in septic patients with AKI versus without AKI.
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fig2: ROC analysis of uNGAL measure on day 1 of admission to the ER in septic patients with AKI versus without AKI.

Mentions: Figures 2–5 display the receiver operator curves (ROC) for uNGAL as predictor of AKI. The areas under the curve for uNGAL1, uNGAL2, uNGAL1/uCr1, and uNGAL2/uCr2 were 0.73, 0.70, 0.77, and 0.84, respectively. Both uNGAL and uNGAL/uCr were good predictors of AKI within the next 48 h. The optimal cutoff value of each one of them had sensitivity and specificity of 0.63 and 0.46, 0.63 and 0.44, 0.7 and 0.38, and 0.75 and 0.43, respectively (Table 4).


Sepsis and AKI in Clinical Emergency Room Patients: The Role of Urinary NGAL.

Nga HS, Medeiros P, Menezes P, Bridi R, Balbi A, Ponce D - Biomed Res Int (2015)

ROC analysis of uNGAL measure on day 1 of admission to the ER in septic patients with AKI versus without AKI.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4516828&req=5

fig2: ROC analysis of uNGAL measure on day 1 of admission to the ER in septic patients with AKI versus without AKI.
Mentions: Figures 2–5 display the receiver operator curves (ROC) for uNGAL as predictor of AKI. The areas under the curve for uNGAL1, uNGAL2, uNGAL1/uCr1, and uNGAL2/uCr2 were 0.73, 0.70, 0.77, and 0.84, respectively. Both uNGAL and uNGAL/uCr were good predictors of AKI within the next 48 h. The optimal cutoff value of each one of them had sensitivity and specificity of 0.63 and 0.46, 0.63 and 0.44, 0.7 and 0.38, and 0.75 and 0.43, respectively (Table 4).

Bottom Line: The uNGAL1 and uNGAL2, as well as uNGAL1/uCr1 and uNGAL2/uCr2, were good predictors for AKI (AUC-ROC 0.73, 0.70, 0.77, and 0.84, resp.).The uNGAL1 and uNGAL1/uCr1 were poor predictors for death (AUC-ROC 0.66 and 0.68, resp.), whereas uNGAL2 and uNGAL2/uCr2 were better predictors (AUC-ROC 0.70 and 0.81, resp.).The uNGAL is highly sensitive but nonspecific predictor of AKI and death in septic patients admitted into ER.

View Article: PubMed Central - PubMed

Affiliation: São Paulo State University (UNESP), Distrito de Rubião Junior, s/n, 18618-970 Botucatu, SP, Brazil.

ABSTRACT

Background: Few studies have investigated the predictive properties of urinary (u) NGAL as an AKI marker in septic population.

Objectives: This study evaluated the efficacy of uNGAL as predictor of AKI and death in septic patients admitted to the clinical emergency room (ER).

Methodology: We prospectively studied patients with sepsis admitted to the ER. Urine was analyzed for NGAL within the first 24 hours after admission (classified as NGAL1), between 24 and 48 h (NGAL2), and at moment of AKI diagnosis (NGAL3).

Results: Among 168 septic patients admitted to ER, 72% developed AKI. The uNGAL and its relationship with creatinine (Cr) were high in septic patients but statistically higher in those with sepsis and AKI. The uNGAL1 and uNGAL2, as well as uNGAL1/uCr1 and uNGAL2/uCr2, were good predictors for AKI (AUC-ROC 0.73, 0.70, 0.77, and 0.84, resp.). The uNGAL1 and uNGAL1/uCr1 were poor predictors for death (AUC-ROC 0.66 and 0.68, resp.), whereas uNGAL2 and uNGAL2/uCr2 were better predictors (AUC-ROC 0.70 and 0.81, resp.).

Conclusion: The uNGAL is highly sensitive but nonspecific predictor of AKI and death in septic patients admitted into ER.

No MeSH data available.


Related in: MedlinePlus