Sollip Kim1, Hyun-Jung Kim2, Hyeong-Sik Ahn2, Ji Yang Song2, Tae-Hyun Um1, Chong-Rae Cho1, Hoon Jung3, Hyeon-Kyoung Koo3, Joo Hyun Park3, Sung-Soon Lee3, Hye Kyeong Park4. 1. Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Gyeonggi, Korea. 2. Department of Preventive Medicine, Korea University Medical College, Seoul, Korea. 3. Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Gyeonggi, Korea. 4. Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Gyeonggi, Korea. Electronic address: stella_park@paik.ac.kr.
Abstract
PURPOSE: Neutrophil gelatinase-associated lipocalin (NGAL) is a useful biomarker for early diagnosis of acute kidney injury (AKI). However, the diagnostic value of NGAL for predicting AKI in sepsis patients is unclear. METHODS: MEDLINE, EMBASE, and Cochrane Library databases were searched to identify research publications. RESULTS: Twelve studies from 9 countries including a total of 1582 patients, of whom 315 (19.9%) developed AKI, were included in the study; plasma NGAL levels were significantly higher in adult sepsis patients with AKI than in those without AKI (mean difference, 274.65; 95% confidence interval [CI], 106.16-443.15; I(2) = 94%). Urine NGAL levels were not significantly different. The diagnostic odds ratio of plasma NGAL for predicting AKI in sepsis patients was 6.64 (95% CI, 3.80-11.58). The diagnostic accuracy of plasma NGAL was 0.881 (95% CI, 0.819-0.923) for sensitivity, 0.474 (95% CI, 0.367-0.582) for specificity, 0.216 (95% CI, 0.177-0.261) for positive predictive value and 0.965 (95% CI, 0.945-0.977) for negative predictive value. CONCLUSION: Plasma NGAL has a high sensitivity and a high negative predictive value for detection of AKI in adult sepsis patients. However, its low specificity and low positive predictive value could limit its clinical utility. The usefulness of urine NGAL was not revealed in this study.
PURPOSE:Neutrophil gelatinase-associated lipocalin (NGAL) is a useful biomarker for early diagnosis of acute kidney injury (AKI). However, the diagnostic value of NGAL for predicting AKI in sepsispatients is unclear. METHODS: MEDLINE, EMBASE, and Cochrane Library databases were searched to identify research publications. RESULTS: Twelve studies from 9 countries including a total of 1582 patients, of whom 315 (19.9%) developed AKI, were included in the study; plasma NGAL levels were significantly higher in adult sepsispatients with AKI than in those without AKI (mean difference, 274.65; 95% confidence interval [CI], 106.16-443.15; I(2) = 94%). Urine NGAL levels were not significantly different. The diagnostic odds ratio of plasma NGAL for predicting AKI in sepsispatients was 6.64 (95% CI, 3.80-11.58). The diagnostic accuracy of plasma NGAL was 0.881 (95% CI, 0.819-0.923) for sensitivity, 0.474 (95% CI, 0.367-0.582) for specificity, 0.216 (95% CI, 0.177-0.261) for positive predictive value and 0.965 (95% CI, 0.945-0.977) for negative predictive value. CONCLUSION: Plasma NGAL has a high sensitivity and a high negative predictive value for detection of AKI in adult sepsispatients. However, its low specificity and low positive predictive value could limit its clinical utility. The usefulness of urine NGAL was not revealed in this study.
Authors: Natalja L Stanski; Erin K Stenson; Natalie Z Cvijanovich; Scott L Weiss; Julie C Fitzgerald; Michael T Bigham; Parag N Jain; Adam Schwarz; Riad Lutfi; Jeffrey Nowak; Geoffrey L Allen; Neal J Thomas; Jocelyn R Grunwell; Torrey Baines; Michael Quasney; Bereketeab Haileselassie; Hector R Wong Journal: Am J Respir Crit Care Med Date: 2020-04-01 Impact factor: 21.405
Authors: James D Odum; Steve Standage; Matthew Alder; Basilia Zingarelli; Prasad Devarajan; Hector R Wong Journal: Shock Date: 2022-02-28 Impact factor: 3.533