Analysis of the diagnostic capabilities of urinary neutrophil gelatinase-associated lipocalin and serum procalcitonin for acute kidney injury at the early stage of critical care intensive care unit admission

J Clin Lab Anal. 2021 Jul;35(7):e23852. doi: 10.1002/jcla.23852. Epub 2021 Jun 8.

Abstract

Background: Acute kidney injury (AKI) is a disease that negatively affects patient prognosis and requires early diagnosis and treatment. Biomarkers that predict AKI are needed for early diagnosis of this disease.

Methods: We compared the AKI group and the non-AKI group in patients who were admitted to our critical care intensive care unit (ICU) and conducted a comparative study focusing on urinary neutrophil gelatinase-associated lipocalin (U-NGAL) and serum procalcitonin (PCT).

Results: Seventy-one out of 106 ICU inpatients were diagnosed with AKI in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Among the patients who were diagnosed with AKI stages 1 to 3, 94.4% of all patients reached the maximum stage by day 5 after admission. Comparing the non-AKI group and AKI stage 1 to 3 on days 1 to 3 after admission, U-NGAL and PCT levels in the stage 3 group were significantly higher than those in the non-AKI group. Additionally, in receiver operating characteristic curve (ROC) analysis on days 1-3 after admission, U-NGAL and PCT levels can be used as biomarkers for the diagnosis of AKI, and in particular, AKI stage 3 can be predicted and diagnosed with high accuracy. U-NGAL and PCT levels were also significantly higher in AKI due to sepsis and acute pancreatitis and due to sepsis, respectively.

Conclusions: Measuring U-NGAL and PCT levels as biomarkers for AKI may further improve the accuracy of AKI diagnosis in critical care ICU.

Keywords: NGAL; acute kidney Injury; pancreatitis; procalcitonin; sepsis.

MeSH terms

  • Acute Kidney Injury / blood*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / urine*
  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • Creatinine / blood
  • Critical Care*
  • Female
  • Hospitalization*
  • Humans
  • Intensive Care Units*
  • Length of Stay
  • Lipocalin-2 / urine*
  • Male
  • Middle Aged
  • Procalcitonin / blood*
  • Prognosis
  • ROC Curve
  • Time Factors

Substances

  • Biomarkers
  • LCN2 protein, human
  • Lipocalin-2
  • Procalcitonin
  • Creatinine