Serum neutrophil gelatinase-associated lipocalin and cystatin C as markers of renal function in patients with stages 2-5 chronic kidney disease

被引:0
作者
Hamid Gohar N.A. [1 ]
Kholousi N. [2 ]
Zeyada R. [1 ]
el Ghar M.A. [2 ]
机构
[1] Clinical and Chemical Pathology, Department of Clinical Chemistry, Cairo University and Hospitals, Cairo
[2] Clinical Pathology, Department of Immunogenetics, National Research Center, Cairo
关键词
CKD; Cystatin C; eGFR; NGAL;
D O I
10.1007/s00580-011-1404-3
中图分类号
学科分类号
摘要
Individuals with reduced glomerular filtration rate (GFR) are at greater risk for cardiovascular disease and other comorbidities. Creatinine-based equations are used to estimate GFR, identify patients with potential kidney disease, and classify them into different stages since serum creatinine is insensitive to changes in the GFR. The aim of our work was to evaluate diagnostic performance of serum cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) as markers of kidney function in patients with reduced GFR. Fifty cases at different stages of renal impairment and 30 healthy control subjects were tested. Only serum NGAL and cystatin C were higher in stage 2 chronic kidney disease (CKD) when compared to the control group (p < 0. 05). For stages 3-5 the median levels of cystatin C, NGAL, and creatinine were found to be significantly higher than the control group. ROC curve constructed to differentiate stage 2 patients from the controls showed AUC for NGAL 0. 795, sensitivity 86%, and specificity 63. 3%; AUC for cystatin C 0. 957, sensitivity 86%, and specificity 90%; and AUC for creatinine 0. 738. Frequency of cases that tested positive for NGAL and cystatin C in stage 2 was higher than those in control group (p < 0. 05) with an OR of 10. 364 (95% CI 1. 099-97. 686) for NGAL and OR 54 (95% CI 4. 7-613) for cystatin C. NGAL and cystatin C exhibited higher sensitivity than creatinine for diagnosis of stage 2 CKD. Their use as adjunctive diagnostic tools in patients with mildly reduced GFR may be justified on the long term to diagnose early renal insult. © 2012 Springer-Verlag London Limited.
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页码:313 / 320
页数:7
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共 42 条
  • [1] Bachorzewska-Gajewska H., Malyszko J., Sitniewska E., Malyszko J.S., Pawlak K., Mysliwiec M., Et al., Could neutrophil-gelatinase-associated lipocalin and cystatin C predict the development of contrast-induced nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine values?, Kidney Blood Press Res, 30, pp. 408-415, (2007)
  • [2] Bennett M., Dent C.L., Ma Q., Dastrala S., Grenier F., Workman R., Et al., Urine NGAL predicts severity of acute kidney injury after cardiac surgery: a prospective study, Clin J Am Soc Nephrol, 3, pp. 665-673, (2008)
  • [3] Bolignano D., Coppolino G., Lacquaniti A., Nicocia G., Buemi M., Pathological and prognostic value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in macroproteinuric patients with worsening renal function, Kidney Blood Press Res, 31, pp. 227-274, (2008)
  • [4] Devarajan P., Neutrophil gelatinase-associated lipocalin: a promising biomarker for human acute kidney injury, Biomark Med, 4, 2, pp. 265-280, (2010)
  • [5] Dharnidharka V.R., Kwon C., Stevens G., Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis, Am J Kidney Dis, 40, pp. 221-226, (2002)
  • [6] Ding H., He Y., Li K., Yang J., Li X., Lu R., Gao W., Urinary neutrophil gelatinase-associated lipocalin is an early biomarker for renal tubulointerstitial injury in IgA nephropathy, Clin Immunol, 123, 2, pp. 227-234, (2007)
  • [7] Eddy A.A., Neilson E.G., Chronic kidney disease progression, J Am Soc Nephrol, 17, pp. 2964-2966, (2006)
  • [8] Filler G., Bokenkamp A., Hofmann W., Bricon T.L., Grubb A., Cystatin C as a marker of GFR-history, indications, and future research, Clin Biochem, 38, pp. 1-8, (2002)
  • [9] Finney H., Newman D.J., Price C.P., Adult reference for serum cystatin C, creatinine and predicted creatinine clearance, Ann Clin Biochem, 37, pp. 49-59, (2002)
  • [10] Flower D.R., North A.C., Sansom C.E., The lipocalin protein family: structural and sequence overview, Biochim Biophys Acta, 1482, pp. 9-24, (2000)