Serum and Urine Neutrophil Gelatinase-Associated Lipocalin Levels Measured at Admission Predict Progression to Chronic Kidney Disease in Sepsis-Associated Acute Kidney Injury Patients

Background. To evaluate the ratio of acute kidney injury (AKI) to chronic kidney disease (CKD) in sepsis-associated acute kidney injury (SA-AKI) patients of the intensive care unit (ICU) and predictive value of neutrophil gelatinase-associated lipocalin (NGAL) measured at the admission time in the progression of AKI to CKD.Methods. A study of 121 consecutive adult patients admitted to the intensive care unit (ICU) diagnosed as SA-AKI. AKI and CKD were defined based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Glomerular filtration rate (GFR) was calculated by the CKD-EPI formula. Serum and urine NGAL was measured using the BioVendor Human Lipocalin-2/NGAL ELISA with a blood sample taken at hospital admission time.Results. The ratio of AKI to CKD in SA-AKI patients was 22.3%. Mean concentration of serum and urine NGAL in AKI to the CKD group was 790.99 ng/ml and 885.72 ng/ml, higher significantly than those of recovery patients (351.86 ng/ml and 264.68 ng/ml),p<0.001. eGFR, both serum and urine NGAL had a predictive value for AKI to CKD (eGFR:AUC=0.857,Se=74.1%,Spe=92.6%,p<0.001. Serum NGAL:AUC=0.868,Se=77.8%,Spe=91.5%. Urine NGAL:AUC=0.869,Se=77.8%,Spe=92.6%,p<0.001.Conclusion. Serum and urine NGAL, measuring at hospital admission time, were good prognostic biomarkers of AKI to CKD in SA-AKI patients.