Association of plasma neutrophil gelatinase-associated lipocalin (NGAL) with sepsis and acute kidney dysfunction

Abstract

Objective: Neutrophil gelatinase-associated lipocalin (NGAL) is secreted by injured kidney cells as well as by activated neutrophils in response to bacterial infections. We assessed the influence of acute renal dysfunction on the association between plasma NGAL and sepsis.

Methods: NGAL was measured daily in 138 critically ill patients. Simultaneous recordings of sepsis status and fluctuations in renal function were made.

Results: Elevated NGAL was associated with sepsis independent of level of acute renal dysfunction. A cut-off value of 98 ng/mL distinguished sepsis from systemic inflammation with high sensitivity (0.77) and specificity (0.79).

Conclusions: Plasma NGAL can help clinicians to identify bacterial infections in critically ill patients.

• Acute kidney injury
• biomarkers
• critical care
• CRP
• inflammation
• PCT

Acknowledgements

The authors thank the research nurses at the Karolinska general ICU, Ola Friman, Åsa Bengtsson and Jenny Svedlund for assistance with plasma sampling and patient recruitment. We thank Dr. Patrik Gille-Johnson at the Department of Infectious Diseases, Karolinska University Hospital, for help with classification of septic patients. The dedication of Lena Moberg and Kerstin Lindblad, laboratory staff at the Department of Clinical Chemistry, Uppsala, is gratefully acknowledged.