RESEARCH ARTICLE


Serum Neutrophil Gelatinase-associated Lipocalin Measured at Admission to Predict Mortality in Sepsis-associated Acute Kidney Injury of Vietnamese Critically Ill Patients



Le V. Thang1, Pham N. H. Tuan5, Nguyen T. Kien1, *, Nguyen T. T. Dung1, Nguyen T. Tue1, Nguyen D. Duong1, Nguyen T. T. Ha1, Diem T. Van1, Nguyen V. Duc1, Vu X. Nghia2, Nguyen H. Dung3, Nguyen T. T. Huong4, Pham T. Dung1
1 Military Hospital 103, Hanoi, Vietnam
2 Vietnam Military Medical University, Hanoi, Vietnam
3 Bach Mai Hospital, Hanoi, Viet Nam
4 Hanoi Kidney Hospital, Hanoi, Vietnam
5 Trung Vuong Hospital, Ho Chi Minh, Vietnam


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© 2018 Thang et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Military Hospital 103, Hanoi, Vietnam; Tel: +841235773357; E-mail: bs.ntkien@gmail.com


Abstract

Purpose:

To evaluate incidence of sepsis-associated acute kidney injury (SA-AKI) in the AKI Intensive Care Unit (ICU) patients and predictive value of Neutrophil Gelatinase-Associated Lipocalin (NGAL) measured at the admission in mortality of SA-AKI and non SA-AKI.

Patients and Methods:

A study of 101 consecutive adult patients admitted to the Intensive Care Unit (ICU) diagnosed as AKI in which there were 60 patients with SA-AKI. Acute kidney injury was defined based on Acute Kidney Injury Network (AKIN) criteria. Serum NGAL was measured using the BioVendor Human Lipocalin-2/NGAL ELISA with blood sample taken at admission.

Results:

Incidence of septic acute kidney injury was 59.4%, incidence of death patients reached 20.0%. Mean concentration of serum NGAL in death group was 633.56 ng/ml, higher significantly than that of survival patients (328.84 ng/ml), p<0.005. Serum NGAL in non SA-AKI patients showed a better prognostic value to predict hospital mortality than that in SA-AKI patients (AUC: 0.894 and 0,807 respectively; p < 0.005)

Conclusion:

In SA-AKI patients, serum NGAL and mortality rate increased along with the stage of AKI. Serum NGAL, measuring at admission time, was a good prognostic biomarker of mortality in both SA-AKI and non SA-AKI patients.

Keywords: AKI, Mortality, SA-AKI, Serum NGAL, Prognostic biomarker.