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Urinary neutrophil gelatinase-associated lipocalin and clinical outcomes in chronic kidney disease patients

  • Hugo You-Hsien Lin ORCID logo , Daw-Yang Hwang , Su Chu Lee , Hung-Tien Kuo , Mei-Chuan Kuo , Jer-Ming Chang , Jer-Chia Tsai , Chi-Chih Hung EMAIL logo , Shang-Jyh Hwang and Hung-Chen Chen
Published/Copyright: August 7, 2014
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 53 Issue 1

Abstract

Background: Tubulointerstitial damage is a final common pathway of most renal diseases. Whether urinary neutrophil gelatinase-associated lipocalin (uNGAL), a biomarker for renal tubular damage, is of prognostic value for clinical outcomes in chronic kidney disease (CKD) patients has not been well investigated.

Methods: The uNGAL and proteinuria levels were measured among a cohort of 473 advanced CKD patients of various etiologies recruited during 2002–2009.

Results: The estimated glomerular filtration rate (eGFR) was 32.3±22.0 mL/min/1.73 m2 with a urine protein-to-creatinine ratio (UPCR) 680 (255–1248) mg/g and 132 (27.9%) participants had diabetes. The baseline uNGAL level was significantly associated with male gender, eGFR, UPCR, and hemoglobin. The hazard ratio (HR) of the highest uNGAL tertile for end-stage renal disease (ESRD) was 3.44 (95% CI 1.47–8.06, p=0.004). With the adjustment of urine creatinine and urine protein, HR of the highest urine NGAL-to-creatinine ratio (UNCR) tertile and the highest urine NGAL-to-protein ratio (UNPR) tertile was 3.06 (95% CI 1.19–7.90, p=0.02) and 2.10 (95% CI 1.13–3.89, p=0.02), respectively. UNPR increased the prediction of survival model for ESRD. HR of the highest UNCR tertile and UNPR tertile for cardiovascular (CV) events was 2.21 (95% CI 0.81–5.98, p=0.08) and 2.79 (95% CI 1.25–6.26, p=0.01), respectively. None of these were associated with all-cause mortality.

Conclusions: Elevated uNGAL in CKD patients is associated with risks for ESRD and probably CV events. UNPR could improve the prediction for ESRD.

Keywords: chronic kidney disease; end-stage renal disease; neutrophil gelatinase-associated lipocalin; proteinuria
Corresponding author: Chi-Chih Hung, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou First Road, Kaohsiung 807, Taiwan, Phone: +886 7 3121101 ext 7351 13, Fax: +886 7 3228721, E-mail:

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Received: 2014-5-9
Accepted: 2014-6-25
Published Online: 2014-8-7
Published in Print: 2015-1-1

©2015 by De Gruyter

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  2. Editorial
  3. Harmonisation of specialist training and continuing professional development in laboratory medicine: a long but necessary journey
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  7. Mini Review
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  10. Comparison of approaches and measurement of continuing professional development for specialists in laboratory medicine within four European countries
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  14. Proteolysis is a confounding factor in the interpretation of faecal calprotectin
  15. Urinary neutrophil gelatinase-associated lipocalin and clinical outcomes in chronic kidney disease patients
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  20. Increased serum homocitrulline concentrations are associated with the severity of coronary artery disease
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  24. Evaluation of a next generation direct whole blood enzymatic assay for hemoglobin A1c on the ARCHITECT c8000 chemistry system
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  27. Letters to the Editor
  28. Comparison of Abbott Architect high-sensitivity troponin I in Rapid Serum Tubes and plasma
  29. Can EDTA, EDTA-fluoride, and buffered citrate tubes be used for measurement of HbA1c on the Bio-Rad D10?
  30. How to reduce EDTA contamination in laboratory specimens: a Tunisian experience
  31. Does mean platelet volume share any relationship with biochemical and hematological parameters?
  32. Association of retrospective markers of glycemia and the use of continuous glucose monitoring in white adults with type 2 diabetes mellitus – a preliminary report
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https://doi.org/10.1515/cclm-2014-0647
Keywords for this article
chronic kidney disease; end-stage renal disease; neutrophil gelatinase-associated lipocalin; proteinuria

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Harmonisation of specialist training and continuing professional development in laboratory medicine: a long but necessary journey
  4. Reviews
  5. Laboratory medicine in the European Union
  6. Role of leptin in female reproduction
  7. Mini Review
  8. Interrelatedness between C-reactive protein and oxidized low-density lipoprotein
  9. General Clinical Chemistry and Laboratory Medicine
  10. Comparison of approaches and measurement of continuing professional development for specialists in laboratory medicine within four European countries
  11. Point-of-care urine albumin in general practice offices: effect of participation in an external quality assurance scheme
  12. Triple positive antiphospholipid antibody profile in outpatients with tests for lupus anticoagulants
  13. Effects of cigarette smoking on circulating leukocytes and plasma cytokines in monozygotic twins
  14. Proteolysis is a confounding factor in the interpretation of faecal calprotectin
  15. Urinary neutrophil gelatinase-associated lipocalin and clinical outcomes in chronic kidney disease patients
  16. Cancer Diagnostics
  17. Quantification of adult T-cell leukemia/lymphoma cells using simple four-color flow cytometry
  18. Serum fucosylated haptoglobin in chronic liver diseases as a potential biomarker of hepatocellular carcinoma development
  19. Cardiovascular Diseases
  20. Increased serum homocitrulline concentrations are associated with the severity of coronary artery disease
  21. S100B concentrations increase perioperatively in jugular vein blood despite limited metabolic and inflammatory response to clinically uneventful carotid endarterectomy
  22. Long-term biological variability of galectin-3 after heart transplantation
  23. Diabetes
  24. Evaluation of a next generation direct whole blood enzymatic assay for hemoglobin A1c on the ARCHITECT c8000 chemistry system
  25. The 13C-glucose breath test is a valid non-invasive screening tool to identify metabolic syndrome in adolescents
  26. Comparison of a direct enzymatic assay and polyacrylamide tube gel electrophoresis for measurement of small, dense low-density lipoprotein cholesterol
  27. Letters to the Editor
  28. Comparison of Abbott Architect high-sensitivity troponin I in Rapid Serum Tubes and plasma
  29. Can EDTA, EDTA-fluoride, and buffered citrate tubes be used for measurement of HbA1c on the Bio-Rad D10?
  30. How to reduce EDTA contamination in laboratory specimens: a Tunisian experience
  31. Does mean platelet volume share any relationship with biochemical and hematological parameters?
  32. Association of retrospective markers of glycemia and the use of continuous glucose monitoring in white adults with type 2 diabetes mellitus – a preliminary report
  33. Operative performances and efficiency for infectious disease testing of two immunochemistry analyzers – Abbott ARCHITECT i2000SR and DiaSorin Liaison XL
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