Admission plasma neutrophil gelatinase associated lipocalin (NGAL) predicts worsening renal function during hospitalization and post discharge outcome in patients with acute heart failure. (September 2014)

• Record Type: Journal Article
• Authors: Palazzuoli, Alberto; Ruocco, Gaetano; Beltrami, Matteo; Franci, Beatrice; Pellegrini, Marco; Lucani, Barbara; Nuti, Ranuccio; Ronco, Claudio
• Is Part Of: Acute cardiac care. Volume 16:Number 3(2014)
• Page Start: 93
• Page End: 101
• Publication Date: 2014-09
• Subjects: Cardiac intensive care -- Periodicals; Cardiovascular system -- Diseases -- Treatment -- Periodicals; 616.12028
• DOI: 10.3109/17482941.2014.911915
• Languages: English
• ISSNs: 1748-2941

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background:</italic> The role of neutrophil gelatinase-associated lipocalin (NGAL) has been described in chronic heart failure (HF), however less data are available in patients admitted for acute HF.</p> <p> <italic>Methods:</italic> We evaluated the role of NGAL in predicting in-hospital worsening renal function (WRF) and post-discharge follow-up during six months period in patients with acute HF. All patients were submitted to creatinine, estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN) and B-type natriuretic peptide (BNP) measurement during hospitalization and before discharge.</p> <p> <italic>Results:</italic> Patients with chronic kidney dysfunction (CKD) demonstrated higher NGAL respect to subject with preserved renal function (241 ± 218 and 130 ± 80 ng/ml; <italic>P</italic> = 0.0001). In subgroup that developed WRF during hospitalization, NGAL levels were significantly increased respect to patients without WRF (272 ± 205 versus 136 ± 127 ng/ml; <italic>P</italic> = 0.0001). A cut off of 134 ng/ml has been related to WRF with good sensibility and specificity (92% and 71% AUC 0.83; <italic>P</italic> = 0.001). Multivariable Cox regression analysis showed that cut-off of 134 ng/ml was the only marker related to death (HR: 1.75; 95% CI: 1.24–2.45; <italic>P</italic> < 0.001). Follow-up analysis confirmed that NGAL > 130 ng/ml was associated with adverse events during a six-month period.</p> <p> <italic>Conclusion:</italic> Admission NGAL measurement appears a sensible tool for in-hospital WRF prediction as well as an early marker for adverse outcome during post discharge vulnerable phase.</p> </abstract>