RESEARCH ARTICLE


Urine Neutrophil Gelatinase-Associated Lipocalin Measured at Admission to Predict Recovery from Acute Kidney Injury of Vietnamese ICU Patients



Le V. Thang1, Nguyen T. Kien1, *, Pham N. H. Tuan5, Nguyen T. T. Dung1, Truong Q. Kien1, Do M. Ha1, Pham Q. Toan1, Nguyen T. T. Ha1, Diem T. Van1, Nguyen Van Duc1, Vu X. Nghia2, Nguyen H. Dung3, Nguyen T. T. Huong4, Hoang T. Vinh1, Le T. Ha6
1 Military Hospital 103, Ha Noi, Viet Nam
2 Vietnam Military Medical University, Ha Noi, Viet Nam
3 Bach Mai Hospital, Ha Noi, Viet Nam
4 Ha Noi Kidney Hospital, Ha Noi, Viet Nam
5 Trung Vuong Hospital, Ho Chi Minh, Viet Nam
6 108 Military Central Hospital, Ha Noi, Viet Nam


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Creative Commons License
© 2019 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 Department of Hematology and Blood Transfusion, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung, Ha Dong, Ha Noi, Vietnam; Tel: +84835773357;
E-mail: bs.ntkien@gmail.com


Abstract

Aims:

To evaluate the predictive value of urine Neutrophil Gelatinase-Associated Lipocalin (NGAL) measured at the time of admission during the recovery from Acute Kidney Injury (AKI) after 90 days.

Materials and Methods:

This study includes 101 adult patients admitted to the Intensive Care Unit (ICU) who were diagnosed as AKI (96 patients had been collected 24-hour urine and 5 patients with anuria). Acute kidney injury was diagnosed using the Acute Kidney Injury Network (AKIN) criteria. Urine NGAL was measured at admission using the BioVendor Human Lipocalin-2/NGAL ELISA.

Results:

The ratio of complete recovery patients after 90 days reached 71.9%. The mean of urine NGAL concentration in the recovery group was 242.04 ng/ml, lower significantly than that of non-recovery patients (371.1 ng/ml), p=0.007. At the cut-off value for 740.03 ng/ml, urine NGAL measured at admission predicted complete recovery with the area under the curve of ROC for urine NGAL = 0.888, p<0.001. Based on the multivariate regression analysis, serum urea, serum creatinine and urine NGAL were independent factors that effected the proportion of recovery in AKI patients (OR=0.856, p=0.023; OR=1.014, p=0.012 and OR=0.993, p<0.001, respectively).

Conclusion:

Serum urea, serum creatinine and urine NGAL were independent factors that effected the proportion of recovery in AKI patients. Urine NGAL in AKI patients measured at the time of the admission time to ICU can be used as a prognostic biomarker of recovery.

Keywords:: AKI, SA-AKI, Urine NGAL, Recovery, ICU, Neutrophil.