The outcome of neutrophil gelatinase-associated lipocalin-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies

Michael Haase, Prasad V Devarajan, Anja Haase-Fielitz, Rinaldo Bellomo, Dinna N Cruz, Gebhard Wagener, Catherine Dent Krawczeski, Jay L Koyner, Patrick Murray, Michael Zappitelli, Stuart L Goldstein, Konstantinos Makris, Claudio Ronco, Johannes Karl Martensson, Claes-Roland Martling, Per Venge, Edward Siew, Lorraine B Ware, Talat Alp Ikizler, Peter Rene Mertens

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Abstract

The aim of this study was to test the hypothesis that, without diagnostic changes in serum creatinine, increased neutrophil gelatinase-associated lipocalin (NGAL) levels identify patients with subclinical acute kidney injury (AKI) and therefore worse prognosis. Background: Neutrophil gelatinase-associated lipocalin detects subclinical AKI hours to days before increases in serum creatinine indicate manifest loss of renal function. Methods: We analyzed pooled data from 2,322 critically ill patients with predominantly cardiorenal syndrome from 10 prospective observational studies of NGAL. We used the terms NGAL(-) or NGAL(+) according to study-specific NGAL cutoff for optimal AKI prediction and the terms sCREA(-) or sCREA(+) according to consensus diagnostic increases in serum creatinine defining AKI. A priori-defined outcomes included need for renal replacement therapy (primary endpoint), hospital mortality, their combination, and duration of stay in intensive care and in-hospital.
Original languageEnglish
Pages (from-to)1752 - 1761
Number of pages10
JournalJournal of the American College of Cardiology
Volume57
Issue number17
DOIs
Publication statusPublished - 2011
Externally publishedYes

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