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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

Urinary NGAL values at three moments after admission in septic patients undergoing AKI during hospitalization.
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fig6: Urinary NGAL values at three moments after admission in septic patients undergoing AKI during hospitalization.

Mentions: Figure 6 shows the values of uNGAL at different moments (1, 2, and 3) in the group of septic patients that developed AKI during the hospitalization. The expression of uNGAL seemed to follow a bimodal pattern around the development of AKI with an early peak preceding AKI followed by a second peak after AKI was established, which was observed only in patients with no AKI at admission.


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)

Urinary NGAL values at three moments after admission in septic patients undergoing AKI during hospitalization.
© Copyright Policy
Related In: Results  -  Collection

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

fig6: Urinary NGAL values at three moments after admission in septic patients undergoing AKI during hospitalization.
Mentions: Figure 6 shows the values of uNGAL at different moments (1, 2, and 3) in the group of septic patients that developed AKI during the hospitalization. The expression of uNGAL seemed to follow a bimodal pattern around the development of AKI with an early peak preceding AKI followed by a second peak after AKI was established, which was observed only in patients with no AKI at admission.

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