Evaluation of Serum Neutrophil Gelatinase-associated Lipocalin in Older Patients with Chronic Kidney Disease

Overview

Journal Aging Med (Milton)

Specialty Geriatrics

Date 2020 Apr 2

PMID 32232190

Citations 8

Authors

Lulu Guo

Bei Zhu

Haichuan Yuan

Weihong Zhao

Affiliations

Soon will be listed here.

Abstract

Objective: Chronic kidney disease (CKD) is a major health-care burden all over the world, and aging is an important risk factor for end-stage renal disease (ESRD). Neutrophil gelatinase-associated lipocalin (NGAL) has been confirmed as a novel marker for early diagnosis of acute kidney injury. Other studies have found that NGAL takes part in the mechanisms of CKD progression. The aim of this study was to evaluate the expression of serum NGAL in CKD, particularly in elderly patients who rapidly progressed to end-stage renal failure.

Methods: Serum NGAL, cystatin C, creatinine, urea, and other factors were evaluated in a cohort of 160 CKD patients (mean age 75.29 ± 12.08 years) with various etiologies.

Results: Serum NGAL was closely related to cystatin C, creatinine, urea, and estimated glomerular filtration rate (eGFR). Special correlations between NGAL and, respectively, anemia and hypoalbuminemia were also found. The cutoff value of NGAL was calculated from Stage 2 to Stage 5. Receiver-operator curve analysis showed good area under the curve (>0.8) and high sensitivity (> 70%) on the cutoff value of NGAL. The NGAL levels increased progressively with the increasing of 2- and 5-year risk of ESRD using the Kidney Failure Risk Equations (KFRE).

Conclusion: In elderly patients with CKD, serum NGAL reflects renal impairment and presents a strong and independent risk marker for progression of ESRD.

Citing Articles

Plasma NGAL, suPAR, KIM-1 and GDF-15 for Improving Glomerular Filtration Rate Estimation in Older Hospitalized Patients.

Houlind M, Nielsen A, Walls A, Christensen L, Nielsen R, Andersen A Basic Clin Pharmacol Toxicol. 2025; 136(3):e70002.

PMID: 39865371 PMC: 11771596. DOI: 10.1111/bcpt.70002.

Evaluating Neutrophil Gelatinase-Associated Lipocalin in Pediatric CKD: Correlations with Renal Function and Mineral Metabolism.

Steflea R, Stoicescu E, Aburel O, Horhat F, Vlad S, Bratosin F Pediatr Rep. 2024; 16(4):1099-1114.

PMID: 39728735 PMC: 11676301. DOI: 10.3390/pediatric16040094.

The Impact of Infections on the Progression of Chronic Kidney Disease.

Dicu-Andreescu I, Capusa C, Garneata L, Ciurea O, Dicu-Andreescu I, Ungureanu E Medicina (Kaunas). 2023; 59(10).

PMID: 37893554 PMC: 10608776. DOI: 10.3390/medicina59101836.

Proficient Novel Biomarkers Guide Early Detection of Acute Kidney Injury: A Review.

Jana S, Mitra P, Roy S Diseases. 2023; 11(1).

PMID: 36648873 PMC: 9844481. DOI: 10.3390/diseases11010008.

Update on prognosis driven classification of pediatric AKI.

Patel M, Gbadegesin R Front Pediatr. 2022; 10:1039024.

PMID: 36340722 PMC: 9634036. DOI: 10.3389/fped.2022.1039024.

References

Zhang L, Zhang P, Wang F, Zuo L, Zhou Y, Shi Y . Prevalence and factors associated with CKD: a population study from Beijing. Am J Kidney Dis. 2008; 51(3):373-84. DOI: 10.1053/j.ajkd.2007.11.009. View

Lewis J, Lim W, Dhaliwal S, Zhu K, Lim E, Thompson P . Estimated glomerular filtration rate as an independent predictor of atherosclerotic vascular disease in older women. BMC Nephrol. 2012; 13:58. PMC: 3411430. DOI: 10.1186/1471-2369-13-58. View

Devireddy L, Teodoro J, Richard F, Green M . Induction of apoptosis by a secreted lipocalin that is transcriptionally regulated by IL-3 deprivation. Science. 2001; 293(5531):829-34. DOI: 10.1126/science.1061075. View

Yang Y, He X, Chen S, Wang L, Li E, Xu L . Changes of serum and urine neutrophil gelatinase-associated lipocalin in type-2 diabetic patients with nephropathy: one year observational follow-up study. Endocrine. 2009; 36(1):45-51. DOI: 10.1007/s12020-009-9187-x. View

Sela S, Shurtz-Swirski R, Cohen-Mazor M, Mazor R, Chezar J, Shapiro G . Primed peripheral polymorphonuclear leukocyte: a culprit underlying chronic low-grade inflammation and systemic oxidative stress in chronic kidney disease. J Am Soc Nephrol. 2005; 16(8):2431-8. DOI: 10.1681/ASN.2004110929. View

Cowland J, Borregaard N . Molecular characterization and pattern of tissue expression of the gene for neutrophil gelatinase-associated lipocalin from humans. Genomics. 1997; 45(1):17-23. DOI: 10.1006/geno.1997.4896. View

Farrington K, Covic A, Aucella F, Clyne N, De Vos L, Findlay A . Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR <45 mL/min/1.73 m2). Nephrol Dial Transplant. 2016; 31(suppl 2):ii1-ii66. DOI: 10.1093/ndt/gfw356. View

Miyata T, van Ypersele de Strihou C . Diabetic nephropathy: a disorder of oxygen metabolism?. Nat Rev Nephrol. 2009; 6(2):83-95. DOI: 10.1038/nrneph.2009.211. View

Malyszko J, Bachorzewska-Gajewska H, Sitniewska E, Malyszko J, Poniatowski B, Dobrzycki S . Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in non-diabetic patients with stage 2-4 chronic kidney disease. Ren Fail. 2008; 30(6):625-8. DOI: 10.1080/08860220802134607. View

10.

Shurtz-Swirski R, Sela S, Herskovits A, Shasha S, Shapiro G, Nasser L . Involvement of peripheral polymorphonuclear leukocytes in oxidative stress and inflammation in type 2 diabetic patients. Diabetes Care. 2001; 24(1):104-10. DOI: 10.2337/diacare.24.1.104. View

11.

Cai L, Rubin J, Han W, Venge P, Xu S . The origin of multiple molecular forms in urine of HNL/NGAL. Clin J Am Soc Nephrol. 2010; 5(12):2229-35. PMC: 2994084. DOI: 10.2215/CJN.00980110. View

12.

White S, Polkinghorne K, Atkins R, Chadban S . Comparison of the prevalence and mortality risk of CKD in Australia using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR estimating equations: the AusDiab (Australian Diabetes, Obesity and.... Am J Kidney Dis. 2010; 55(4):660-70. DOI: 10.1053/j.ajkd.2009.12.011. View

13.

Al-Aly Z, Zeringue A, Fu J, Rauchman M, McDonald J, El-Achkar T . Rate of kidney function decline associates with mortality. J Am Soc Nephrol. 2010; 21(11):1961-9. PMC: 3014010. DOI: 10.1681/ASN.2009121210. View

14.

Bolignano D, Lacquaniti A, Coppolino G, Donato V, Campo S, Fazio M . Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009; 4(2):337-44. PMC: 2637601. DOI: 10.2215/CJN.03530708. View

15.

Mitsnefes M, Kathman T, Mishra J, Kartal J, Khoury P, Nickolas T . Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in children with chronic kidney disease. Pediatr Nephrol. 2006; 22(1):101-8. DOI: 10.1007/s00467-006-0244-x. View

16.

Viau A, Karoui K, Laouari D, Burtin M, Nguyen C, Mori K . Lipocalin 2 is essential for chronic kidney disease progression in mice and humans. J Clin Invest. 2010; 120(11):4065-76. PMC: 2964970. DOI: 10.1172/JCI42004. View

17.

Friedl A, Stoesz S, Buckley P, Gould M . Neutrophil gelatinase-associated lipocalin in normal and neoplastic human tissues. Cell type-specific pattern of expression. Histochem J. 1999; 31(7):433-41. DOI: 10.1023/a:1003708808934. View

18.

Coca S . Acute kidney injury in elderly persons. Am J Kidney Dis. 2010; 56(1):122-31. PMC: 2902696. DOI: 10.1053/j.ajkd.2009.12.034. View

19.

Arora P, Vasa P, Brenner D, Iglar K, McFarlane P, Morrison H . Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey. CMAJ. 2013; 185(9):E417-23. PMC: 3680588. DOI: 10.1503/cmaj.120833. View

20.

Hemdahl A, Gabrielsen A, Zhu C, Eriksson P, Hedin U, Kastrup J . Expression of neutrophil gelatinase-associated lipocalin in atherosclerosis and myocardial infarction. Arterioscler Thromb Vasc Biol. 2005; 26(1):136-42. DOI: 10.1161/01.ATV.0000193567.88685.f4. View