Using NGAL as an Early Diagnostic Test of Acute Kidney Injury

Figures & data

Table 1. sNGAL and uNGAL concentrations in humans without acute kidney injury (AKI) (prior to injury).

Population	NGAL concentration	Reference
Noncardiac major surgery	93 ng/L ± 38 (serum)	Shavit et al.^22
Noncardiac major surgery	83 ng/L ± 234 (urine)	Shavit et al.^22
Critically ill children	14.2 ng/mL ± 27 (urine)	Zappitelli et al.^27
Critically ill adults	48.1 ng/mL (urine), IQR(12.7–179.3)	Siew et al.^28

Notes: Mean values (95% CI) ± SD. uNGAL, neutrophil gelatinase-associated lipocalin in urine; sNGAL, neutrophil gelatinase-associated lipocalin in serum; CI, confidence interval.

Table 2. Sensitivity and specificity of NGAL assessment for detection of AKI across patient populations.

Population	Size	Serum/uNGAL	Sensitivity (%)	Specificity (%)	Note	Study
Premature infants with oliguria	20	Urine	31	88	Birth weight and development were listed as confounding factors	Lavery et al.^32
Noncardiac major surgery	74	Urine	60	31	2 h post-op finding	Shavit et al.^22
		Serum	70	46	6 h finding had only marginal increase in sensitivity and 4–5% increase in specificity >90% of subjects had pre-existing CKD or risk factors for CKD
Liver	92	Urine	83.5	67.5	Maximized 3 h post-op by uNGAL/creatinine ratio	Wagener et al.^25
Critically ill multi-trauma	31	Urine	91	95		Makris et al.^29

Note: NGAL, neutrophil gelatinase-associated lipocalin; AKI, acute kidney injury; CKD, chronic kidney disease; uNGAL, neutrophil gelatinase-associated lipocalin in urine.

Shavit L, Dolgoker I, Ivgi H, Assous M, Slotki I. Neutrophil gelatinase-associated lipocalin as a predictor of complications and mortality in patients undergoing non-cardiac major surgery. Kidney Blood Press Res. 2011;34:116–124.

 PubMed Web of Science ®Google Scholar

Zappitelli M, Washburn KK, Arikan AA, . Urine neutrophil gelinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: A prospective cohort study. Crit Care. 2007;11:R84.

 PubMed Web of Science ®Google Scholar

Siew ED, Ware LB, Gebretsadik T, . Urine neutrophil gelitinase-associated lipocalin moderately predicts acute kidney injury in critically ill adults. J Am Soc Nephrol. 2009;20:1823–1832.

 PubMed Web of Science ®Google Scholar

Bagshaw SM, Bennett M, Haase M, . Plasma and urine neutrophil gelatinase-associated lipocalin in septic vs. non-septic acute kidney injury in critical illness. Intensive Care Med. 2009;36:452–461.

 PubMed Web of Science ®Google Scholar