Neutrophil Gelatinase Associated Lipocalin (NGAL) in Leptospirosis Acute Kidney Injury: A Multicenter Study in Thailand

• DOI: 10.1371/journal.pone.0143367
• Publication Date: 2015-12-02T18:59:53Z
• Authors: Nattachai Srisawat; Kearkiat Praditpo...; Kanitha Patarakul; Malee Techapornrung; Tinnapop Daraswang; Theerapon Sukmark; Kamol Khositrangs...; Apinya Fakthongyoo; Petchdee Oranrigs...; Laksamon Praderm; Ummarit Suwattana...; Sadudee Peeraporn...; Passisd Loahaveer...; Nattachai Suwachi...; Thaksa-on Wirotwan; Chayanat Phonork; Sarinya Kumpunya; Khajohn Tiranatha...; Chintana Chiratha...; Somchai Eiam-ong; Kriang Tungsanga; Visith Sitprija; John A. Kellum; Natavudh Townamchai
• Keywords: Male; Science; Lipocalin; Urine; Kidney; 03 medical and health sciences; 0302 clinical medicine; Lipocalin-2; Proto-Oncogene Proteins; Sepsis; Dipstick; Pathology; Humans; Leptospirosis; Internal medicine; Immunology and Microbiology; Leptospira; Q; R; Life Sciences; Recovery of Function; Acute Kidney Injury; Middle Aged; Thailand; Lipocalins; Leptospirosis: Zoonotic Disease and Global Impact; Acute kidney injury; 3. Good health; Treatment Outcome; Medicine; Female; Parasitology; Dialysis; Biomarkers; Research Article; Acute-Phase Proteins

AKI is one of the most serious complications leptospirosis, an important zoonosis in tropics. Recently, NGAL, novel biomarkers, extensively studied various specific settings such as sepsis, cardiac surgery, and radiocontrast nephropathy. In this multicenter study, we aimed to study role NGAL early marker outcome predictor leptospirosis associated AKI. Patients who presented with clinical suspiciousness were prospectively enrolled 9 centers from August 2012 November 2014. The first day enrollment was suspicious leptospirosis. Blood urine samples serially collected on three days 7 after enrollment. We used standard techniques (microscopic agglutination test, direct culture, PCR technique) confirm diagnosis KDIGO criteria for diagnosis. Recovery defined alive not requiring dialysis during hospitalization or maintaining maximum stage at hospital discharge. Of 221 recruited cases, 113 cases confirmed cases. Thirty seven percent developed Median uNGAL pNGAL levels those developing significantly higher than patients [253.8 (631.4) vs 24.1 (49.6) ng/ml, p < 0.001] [1,030 (802.5) 192.0 (209.0) 0.001], respectively. had AUC-ROC 0.91, 0.92, Both level between AKI-recovery group AKI-non recovery comparable. From provided promising result be a However, both them did show potential renal setting.