Neutrophil gelatinase-associated lipocalin predicts worsening of renal function in acute heart failure

• DOI: 10.2459/jcm.0b013e3283629ca6
• Publication Date: 2013-06-26T11:19:21Z
• Authors: Andrea Mortara; Marika Bonadies; Simone Mazzetti; Ilenia Fracchioni; Pietro Delfino; Margherita Chioffi; Chiara Bersano; Giuseppe Specchia
• Keywords: Neutrophil gelatinase-associated lipocalin

Worsening of renal function (WRF) in acute heart failure (AHF) strongly predicts adverse clinical outcome. Plasma neutrophil gelatinase-associated lipocalin (NGAL) has been proposed as an earlier biomarker tubular damage, but important methodological issues remain unsolved, particularly AHF.In 30 consecutive patients admitted for AHF, 108 serum NGAL (Alere system) measurements were performed at entry and the first days recovery, reproducibility within same blood samples was very high (r = 0.98). related to kidney [r 0.51 vs. creatinine (Cr) r -0.49 estimated glomerular filtration rate (eGFR), both P < 0.001], weakly with hemoglobin -0.36, 0.05) C-reactive protein (CRP) 0.26, 0.05). During hospitalization, WRF occurred 26.7% patients. Baseline only slightly higher who developed compared those did not (151 ± 90 119 75 ng/ml, NS), it increased significantly following days, always preceding occurrence (max. previous 24 h, average 95%, range 25-200%). The area under Receiver Operating Characteristic (ROC) curve (AUC-ROC) 0.69 pathological 0.91 delta changes during days.In measurement is highly reproducible baseline Cr eGFR, does predict subsequent hospitalization. On contrary, serial hospitalization can accurately WRF.