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Performance of urinary NGAL and L-FABP in predicting acute kidney injury and subsequent renal recovery: a cohort study based on major surgeries

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Published/Copyright: November 29, 2013
Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 52 Issue 5

Abstract

Background: Acute kidney injury (AKI) is a frequent complication of major surgery. The current study evaluated the power of two biomarkers [urinary neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid binding protein (L-FABP)] to detect the occurrence of AKI and to predict the recovery from renal dysfunction in a major surgery cohort.

Methods: In this prospective study, 199 patients undergoing major surgery were enrolled. Urinary samples collected from participants before surgery, and 0, 4, and 12 h and 1, 2, 7, and 14 days after surgery were tested for NGAL and L-FABP.

Results: Thirty-seven (18.6%) subjects developed AKI. Urinary NGAL and L-FABP were significantly increased from the time surgery was completed (p<0.05). The peak levels of NGAL and L-FABP occurred 12 and 4 h postoperatively (16.4- and 172.0-fold compared to baseline) in AKI group, respectively. The area under the receiver operating characteristic (ROC) curve (AUC) in NGAL (at 12 h), L-FABP (at 4 h), the most predictive model (NGAL at 12 h+L-FABP at 4 h), and the best combination at the same time point (12 h) was 0.83 [95% confidence interval (CI), 0.74–0.91], 0.85 (95% CI 0.77–0.93), 0.94 (95% CI 0.89–0.98), and 0.91 (95% CI 0.85–0.97), respectively. However, the largest AUC of single and combined biomarkers for predicting non-recovery after AKI only reached 0.70.

Conclusions: Urinary NGAL and L-FABP can be used to detect AKI and combining NGAL and L-FABP may improve the diagnostic performance; however, NGAL and L-FABP may be poor predictors for renal recovery after AKI.

Keywords: acute kidney injury; diagnostic biomarker; liver-type fatty acid-binding protein; neutrophil gelatinase-associated lipocalin; prognostic biomarker
Corresponding author: Xian-Fei Zeng, Department of Laboratory Medicine, Shaanxi Corps Hospital of Chinese People’s Armed Police Forces, 88 South 2nd Ring Road, Xi’an, P. R. China 710054, Phone: +86 29 82246003, Fax: +86 29 62226197, E-mail:

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Received: 2013-9-30
Accepted: 2013-10-21
Published Online: 2013-11-29
Published in Print: 2014-5-1

©2014 by Walter de Gruyter Berlin/Boston

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  1. Frontmatter
  2. Editorial
  3. Potential application of fetal epigenetic markers on the non-invasive prenatal detection of chromosomal abnormality
  4. Review
  5. Epigenetic mechanisms in bone
  6. Opinion Papers
  7. Circulating fetal cell-free DNA and prenatal molecular diagnostics: are we ready for consensus?
  8. Hepcidin levels in chronic hemodialysis patients: a critical evaluation
  9. D-dimer testing for suspected venous thromboembolism in the emergency department. Consensus document of AcEMC, CISMEL, SIBioC, and SIMeL
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  11. Effect of biobanking conditions on short-term stability of biomarkers in human serum and plasma
  12. Non-invasive detection of fetal trisomy 21 using fetal epigenetic biomarkers with a high CpG density
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  14. Instability of cerebrospinal fluid after delayed storage and repeated freezing: a holistic study by drop coating deposition Raman spectroscopy
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  16. Performance of urinary NGAL and L-FABP in predicting acute kidney injury and subsequent renal recovery: a cohort study based on major surgeries
  17. Rapid extraction, identification and quantification of drugs of abuse in hair by immunoassay and ultra-performance liquid chromatography tandem mass spectrometry
  18. Validity and reliability of the 13C-methionine breath test for the detection of moderate hyperhomocysteinemia in Mexican adults
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  26. Cardiovascular Diseases
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  28. Low serum adropin is associated with coronary atherosclerosis in type 2 diabetic and non-diabetic patients
  29. Corrigendum
  30. Standardization and analytical goals for glycated hemoglobin measurement
  31. Letter to the Editors
  32. Do we need to worry about contamination by circulating fetal DNA?
  33. Stat testing utilization in clinical laboratories. National survey of Italian Society of Clinical Biochemistry and Molecular Biology (SIBioC)
  34. Aldosterone measurement with LiaisonXL automated system: remarks about reference range
  35. Better blood collection tubes for plasma glucose: ready for prime time?
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https://doi.org/10.1515/cclm-2013-0823
Keywords for this article
acute kidney injury; diagnostic biomarker; liver-type fatty acid-binding protein; neutrophil gelatinase-associated lipocalin; prognostic biomarker

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Potential application of fetal epigenetic markers on the non-invasive prenatal detection of chromosomal abnormality
  4. Review
  5. Epigenetic mechanisms in bone
  6. Opinion Papers
  7. Circulating fetal cell-free DNA and prenatal molecular diagnostics: are we ready for consensus?
  8. Hepcidin levels in chronic hemodialysis patients: a critical evaluation
  9. D-dimer testing for suspected venous thromboembolism in the emergency department. Consensus document of AcEMC, CISMEL, SIBioC, and SIMeL
  10. General Clinical Chemistry and Laboratory Medicine
  11. Effect of biobanking conditions on short-term stability of biomarkers in human serum and plasma
  12. Non-invasive detection of fetal trisomy 21 using fetal epigenetic biomarkers with a high CpG density
  13. Development and validation of dried matrix spot sampling for the quantitative determination of amyloid β peptides in cerebrospinal fluid
  14. Instability of cerebrospinal fluid after delayed storage and repeated freezing: a holistic study by drop coating deposition Raman spectroscopy
  15. Analysis of patients with γ-heavy chain disease by the heavy/light chain and free light chain assays
  16. Performance of urinary NGAL and L-FABP in predicting acute kidney injury and subsequent renal recovery: a cohort study based on major surgeries
  17. Rapid extraction, identification and quantification of drugs of abuse in hair by immunoassay and ultra-performance liquid chromatography tandem mass spectrometry
  18. Validity and reliability of the 13C-methionine breath test for the detection of moderate hyperhomocysteinemia in Mexican adults
  19. Quantitative detection of target cells using unghosted cells (UGCs) of DxH 800 (Beckman Coulter)
  20. Evaluation of different sized blood sampling tubes for thromboelastometry, platelet function, and platelet count
  21. Cancer Diagnostics
  22. Routine use of the Ion Torrent AmpliSeq™ Cancer Hotspot Panel for identification of clinically actionable somatic mutations
  23. Analytical performance of a new one-step quantitative prostate-specific antigen assay, the FREND™ PSA Plus
  24. Relationship between prostate-specific antigen kinetics and detection rate of radiolabelled choline PET/CT in restaging prostate cancer patients: a meta-analysis
  25. Methylation of OPCML promoter in ovarian cancer tissues predicts poor patient survival
  26. Cardiovascular Diseases
  27. Red blood cell distribution width predicts survival in patients with Eisenmenger syndrome
  28. Low serum adropin is associated with coronary atherosclerosis in type 2 diabetic and non-diabetic patients
  29. Corrigendum
  30. Standardization and analytical goals for glycated hemoglobin measurement
  31. Letter to the Editors
  32. Do we need to worry about contamination by circulating fetal DNA?
  33. Stat testing utilization in clinical laboratories. National survey of Italian Society of Clinical Biochemistry and Molecular Biology (SIBioC)
  34. Aldosterone measurement with LiaisonXL automated system: remarks about reference range
  35. Better blood collection tubes for plasma glucose: ready for prime time?
  36. Upregulation of cytokines and IL-17 in patients with hereditary angioedema
  37. Underestimation of platelet count on magnesium salt-anticoagulated samples
  38. Extensive elevation of BNP but not NT-ProBNP in a patient with advanced urothelial carcinoma in absence of cardiac failure and volume overload
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