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Increased urinary neutrophil gelatinase associated lipocalin in urinary tract infections and leukocyturia
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An-Sofie C. Decavele
Published/Copyright:
March 11, 2011
Abstract
Background: Neutrophil gelatinase associated lipocalin (NGAL) is a protein present in neutrophils. NGAL is a promising biomarker for acute kidney injury. In urinary tract infections, urinary neutrophils can be a potential source of urinary NGAL. We investigated the effects of urinary tract infection and urinary neutrophil counts on urinary NGAL values.
Methods: NGAL was assayed using an immunoassay (ARCHITECT). Urine flowcytometry was performed with the UF-1000i (Sysmex).
Results: A correlation between the urinary white blood cell (WBC) count and NGAL concentrations was observed: log(Y) (NGAL, μg/L)=1.284+0.439 log(X) (urinary WBC, 109 cells/L); r=0.518. Similarly, the bacterial count correlated weakly with NGAL: log(Y) (NGAL, μg/L)=1.796+0.124 log(X) (bacterial count, 109 cells/L); r=0.243. Albuminuria correlated moderately with NGAL values: log(Y) (NGAL, μg/L)=1.557+0.339 log(X) (albuminuria, mg/L); r=0.368; α1-microglobulin (a1M) correlated weakly with NGAL: log(Y) (NGAL, μg/L)=1.631+0.360 log(X) (a1M, mg/L); r=0.381.
Conclusions: Leukocyte contributions to urinary NGAL concentrations can be important. In leukocyturia or tubular damage (e.g., intensive care patients), using a fixed cut-off value for interpreting urinary NGAL data can lead to false positive results. Therefore, we suggest a mathematical correction in cases with pyuria (>100×109 cells/L) and urinary NGAL concentration >100 μg/L: corrected NGAL (μg/L)=NGAL–0.12 (urinary WBC, 109 cells/L).
Keywords: acute kidney injury; albuminuria; α1-microglobulin; leukocytes; neutrophil gelatinase associated lipocalin (NGAL); urinary tract infection
Received: 2010-10-11
Accepted: 2011-1-9
Published Online: 2011-03-11
Published in Print: 2011-06-01
©2011 by Walter de Gruyter Berlin Boston
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Keywords for this article
acute kidney injury;
albuminuria;
α1-microglobulin;
leukocytes;
neutrophil gelatinase associated lipocalin (NGAL);
urinary tract infection
Articles in the same Issue
- Editors’ and Publisher’s Note
- CCLM Award for The Most Cited Paper Recently Published
- Reviews
- Some views on proteomics in diabetes
- Cancer biomarkers for hepatocellular carcinomas: from traditional markers to recent topics
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- Opinion Paper
- Focusing on the clinical impact of standardization of creatinine measurements: a report by the EFCC Working Group on Creatinine Standardization
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- Use of a fully automated immunoassay for celiac disease screening in a pediatric population
- Evaluation of four commercial biuret reagent kits of serum total protein by the American Association for Clinical Chemistry reference measurement procedure
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