Neutrophil gelatinase-associated lipocalin (NGAL), also known as lipocalin-2, is a 178-amino acid protein which exists in three molecular forms, including a 25-kDa monomer, a 45-kDa homodimer, and a 135-kDa heterodimer complexed with matrix metalloproteinase 9 (MMP-9). Polymorphonuclear neutrophils and tubular cells of the kidney are the most representative cellular sources. As such, NGAL is now considered the biochemical gold standard for early diagnosis of acute kidney injury. Recent evidence suggests, however, that ectopic or enhanced expression of NGAL may occur in many other pathologic conditions including cancer. Several epidemiologic studies, as reviewed in this chapter, showed that a variety of malignant tumors consistently overexpressed NGAL with increased concentration in blood, urine, and other biologic fluids. In addition, NGAL was frequently associated with tumor size, stage, and invasiveness. These features thus make it a potential biomarker for malignancy. A number of experimental studies also demonstrated that the ability to bind MMP-9, to scavenge iron into cancer cells along with the effect on subcellular localization of transmembrane proteins such as cadherins and catenins, confers this protein the potential to enhance can cer aggressiveness and makes it an appealing target of future anticancer research.
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Plasma neutrophil gelatinase-associated lipocalin as a single test rule out biomarker for acute kidney injury: A cross-sectional study in patients admitted to the emergency department.
PLoS One
January 2025
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Objectives: Acute kidney injury (AKI) is a syndrome with high mortality and morbidity in part due to delayed recognition based on changes in creatinine. A marker for AKI based on a single measurement is needed and therefore the performance of a single measurement of plasma neutrophil gelatinase-associated lipocalin (pNGAL) to predict AKI in patients admitted to the emergency department was tested.
Methods: Samples from the Triage study which included 6005 consecutive adult patients admitted to the emergency department were tested for pNGAL.
The XpressCard Point-of-Care Test for Human Neutrophil Gelatinase-Associated Lipocalin Enhances the Prediction of Acute Kidney Injury.
J Clin Med
December 2024
Department of Health Management, Economics and Policy, The Graduate School, Augusta University, Augusta, GA 30912, USA.
Acute kidney injury (AKI), a common complication in hospitalized patients, is a clinical syndrome with a sudden and reversible decline in kidney function. Within hospitalization, the average incidence rate is 2% to 5%, and 67% of patients admitted to the Intensive Care Unit (ICU) acquire acute kidney injury. There is a pressing need to identify biomarkers that provide early detection to enhance the diagnosis of acute kidney injury.
View Article and Find Full Text PDFSepsis-Associated Acute Kidney Injury: What's New Regarding Its Diagnostics and Therapeutics?
Diagnostics (Basel)
December 2024
First Department of Internal Medicine, Sismanogleio General Hospital, 15126 Athens, Greece.
Sepsis-associated acute kidney injury (SA-AKI) is defined as the development of AKI in the context of a potentially life-threatening organ dysfunction attributed to an abnormal immune response to infection. SA-AKI has been associated with increased mortality when compared to sepsis or AKI alone. Therefore, its early recognition is of the utmost importance in terms of its morbidity and mortality rates.
View Article and Find Full Text PDFRandomized Trial of Early versus Standard Renal Replacement Therapy in Patients with Acute Kidney Injury After Type A Aortic Dissection.
Ann Thorac Surg
January 2025
Center for Cardiac Surgical Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. Electronic address:
Background: We seek to study whether early initiation of renal replacement therapy (RRT) could reduce 90-day mortality and improve clinical outcomes in patients with acute kidney injury following acute type A aortic dissection.
Methods: This is a single-center, randomized, controlled trial that enrolled acute type A aortic dissection patients with severe post-operative acute kidney injury (Kidney Disease: Improving Global Outcomes (KDIGO) stage 2) and with plasma neutrophil gelatinase-associated lipocalin level > 150 ng/mL who did not have potentially life-threatening complications directly related to renal failure. Patients were randomized equally into two groups: the early RRT group received RRT within 6 hours of diagnosis of KDIGO stage 2; the standard treatment group was managed with RRT initiated within 8 hours of stage 3.
Predictive Value of Kidney Failure Risk Equation and Neutrophil Gelatinase-Associated Lipocalin for Chronic Kidney Disease Progression in Chinese Population - A Retrospective Study.
Int J Gen Med
December 2024
Department of Oncology, Jiangjin Central Hospital, Chongqing, 402260, People's Republic of China.
Article Synopsis
- The study analyzed the association of the Kidney Failure Risk Equation (KFRE) and neutrophil gelatinase-associated lipocalin (NGAL) with the risk of developing end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD) stages 3-5 in China.
- The research included 716 CKD patients and found that the 2-year incidence of ESRD was 20.5%.
- Results indicated that both KFRE and NGAL were independently linked to ESRD, with combined use significantly enhancing predictive accuracy compared to using either marker alone.
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