Naledi Moyake1, Eckhart Buchmann2, Nigel J Crowther3. 1. Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa. nmoyake@gmail.com. 2. Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa. 3. Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa.
Abstract
AIM: Neutrophil gelatinase-associated lipocalin (NGAL) is an emerging biomarker for early diagnosis of acute kidney injury (AKI). This study investigated the use of urinary NGAL as a marker of AKI in women with pre-eclampsia. METHODS: Urine and serum samples were collected over 24 h from 78 healthy and 109 pre-eclamptic women, with baseline samples taken at admission to the maternity unit; NGAL was assayed in serial urine samples. RESULTS: Baseline neutrophil gelatinase-associated lipocalin did not differ significantly between women who were healthy, those with pre-eclampsia, or with AKI (P = 0.55 for trend). When the pre-eclamptic group was divided into those with eclampsia (median, 60.5 ng/mL; IQR, 23.4-173 ng/mL; n = 19), uncomplicated pre-eclampsia (median, 18.8 ng/mL; IQR, 7.5-52.8 ng/mL; n = 48; P < 0.05 vs eclampsia), imminent eclampsia (median, 30.7 ng/mL; IQR, 13.9-49.3 ng/mL; n = 22) and pre-eclampsia with acute kidney injury (median, 60.3 ng/mL; IQR, 23.5-159 ng/mL, n = 14), however, NGAL level did differ. On multivariate regression analysis, the only significant correlate of NGAL level was the presence of eclampsia (beta = 0.22, P < 0.05). On receiver operating characteristic curve analysis, baseline NGAL did not discriminate between subjects with or without AKI (area under the curve, 0.61; 95%CI: 0.43-0.78; P = 0.12). CONCLUSION: Neutrophil gelatinase-associated lipocalin level at baseline and over a 24-h period does not provide a suitable diagnostic test for AKI in pre-eclamptic subjects.
AIM: Neutrophil gelatinase-associated lipocalin (NGAL) is an emerging biomarker for early diagnosis of acute kidney injury (AKI). This study investigated the use of urinary NGAL as a marker of AKI in women with pre-eclampsia. METHODS: Urine and serum samples were collected over 24 h from 78 healthy and 109 pre-eclamptic women, with baseline samples taken at admission to the maternity unit; NGAL was assayed in serial urine samples. RESULTS: Baseline neutrophil gelatinase-associated lipocalin did not differ significantly between women who were healthy, those with pre-eclampsia, or with AKI (P = 0.55 for trend). When the pre-eclamptic group was divided into those with eclampsia (median, 60.5 ng/mL; IQR, 23.4-173 ng/mL; n = 19), uncomplicated pre-eclampsia (median, 18.8 ng/mL; IQR, 7.5-52.8 ng/mL; n = 48; P < 0.05 vs eclampsia), imminent eclampsia (median, 30.7 ng/mL; IQR, 13.9-49.3 ng/mL; n = 22) and pre-eclampsia with acute kidney injury (median, 60.3 ng/mL; IQR, 23.5-159 ng/mL, n = 14), however, NGAL level did differ. On multivariate regression analysis, the only significant correlate of NGAL level was the presence of eclampsia (beta = 0.22, P < 0.05). On receiver operating characteristic curve analysis, baseline NGAL did not discriminate between subjects with or without AKI (area under the curve, 0.61; 95%CI: 0.43-0.78; P = 0.12). CONCLUSION:Neutrophil gelatinase-associated lipocalin level at baseline and over a 24-h period does not provide a suitable diagnostic test for AKI in pre-eclamptic subjects.
Authors: Elsa De La Chesnaye; Leticia Manuel-Apolinar; Leticia Damasio; Aleida Olivares; Miguel Angel Palomino; Isis Santos; Juan Pablo Méndez Journal: Exp Ther Med Date: 2018-05-18 Impact factor: 2.447