Neutrophil gelatinase-associated lipocalin: Ready for routine clinical use? An international perspective

Claudio Ronco, Matthieu Legrand, Stuart L. Goldstein, Mina Hur, Nam Tran, Eric C. Howell, Vincenzo Cantaluppi, Dinna N. Cruz, Kevin Damman, Sean M. Bagshaw, Salvatore Di Somma, Andrew Lewington

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Acute kidney injury (AKI) remains a challenge in terms of diagnosis and classification, its morbidity and mortality remaining high in the face of improving clinical protocols. Current clinical criteria use serum creatinine (sCr) and urine output to classify patients. Ongoing research has identified novel biomarkers that may improve the speed and accuracy of patient evaluation and prognostication, yet the route from basic science to clinical practice remains poorly paved. International evidence supporting the use of plasma neutrophil gelatinase-associated lipocalin (NGAL) as a valuable biomarker of AKI and chronic kidney disease (CKD) for a number of clinical scenarios was presented at the 31st International Vicenza Course on Critical Care Nephrology, and these data are detailed in this review. NGAL was shown to be highly useful alongside sCr, urinary output, and other biomarkers in assessing kidney injury; in patient stratification and continuous renal replacement therapy (CRRT) selection in paediatric AKI; in assessing kidney injury in conjunction with sCr in sepsis; in guiding resuscitation protocols in conjunction with brain natriuretic peptide in burn patients; as an early biomarker of delayed graft function and calcineurin inhibitor nephrotoxicity in kidney transplantation from extended criteria donors; as a biomarker of cardiovascular disease and heart failure, and in guiding CRRT selection in the intensive care unit and emergency department. While some applications require further clarification by way of larger randomised controlled trials, NGAL nevertheless demonstrates promise as an independent biological marker with the potential to improve earlier diagnosis and better assessment of risk groups in AKI and CKD. This is a critical element in formulating quick and accurate decisions for individual patients, both in acute scenarios and in long-term care, in order to improve patient prognostics and outcomes.

Original languageEnglish (US)
Pages (from-to)271-285
Number of pages15
JournalBlood Purification
Volume37
Issue number4
DOIs
StatePublished - Nov 13 2014

Fingerprint

Internationality
Biomarkers
Acute Kidney Injury
Creatinine
Renal Replacement Therapy
Chronic Renal Insufficiency
Serum
Delayed Graft Function
Kidney
Nephrology
Brain Natriuretic Peptide
Wounds and Injuries
Long-Term Care
Critical Care
Clinical Protocols
Resuscitation
Kidney Transplantation
Intensive Care Units
Lipocalin-2
Hospital Emergency Service

Keywords

  • Acute kidney injury
  • Chronic kidney disease
  • Neutrophil gelatinase-associated lipocalin

ASJC Scopus subject areas

  • Nephrology
  • Hematology

Cite this

Ronco, C., Legrand, M., Goldstein, S. L., Hur, M., Tran, N., Howell, E. C., ... Lewington, A. (2014). Neutrophil gelatinase-associated lipocalin: Ready for routine clinical use? An international perspective. Blood Purification, 37(4), 271-285. https://doi.org/10.1159/000360689

Neutrophil gelatinase-associated lipocalin : Ready for routine clinical use? An international perspective. / Ronco, Claudio; Legrand, Matthieu; Goldstein, Stuart L.; Hur, Mina; Tran, Nam; Howell, Eric C.; Cantaluppi, Vincenzo; Cruz, Dinna N.; Damman, Kevin; Bagshaw, Sean M.; Somma, Salvatore Di; Lewington, Andrew.

In: Blood Purification, Vol. 37, No. 4, 13.11.2014, p. 271-285.

Research output: Contribution to journalArticle

Ronco, C, Legrand, M, Goldstein, SL, Hur, M, Tran, N, Howell, EC, Cantaluppi, V, Cruz, DN, Damman, K, Bagshaw, SM, Somma, SD & Lewington, A 2014, 'Neutrophil gelatinase-associated lipocalin: Ready for routine clinical use? An international perspective', Blood Purification, vol. 37, no. 4, pp. 271-285. https://doi.org/10.1159/000360689
Ronco, Claudio ; Legrand, Matthieu ; Goldstein, Stuart L. ; Hur, Mina ; Tran, Nam ; Howell, Eric C. ; Cantaluppi, Vincenzo ; Cruz, Dinna N. ; Damman, Kevin ; Bagshaw, Sean M. ; Somma, Salvatore Di ; Lewington, Andrew. / Neutrophil gelatinase-associated lipocalin : Ready for routine clinical use? An international perspective. In: Blood Purification. 2014 ; Vol. 37, No. 4. pp. 271-285.
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