Neutrophil gelatinase associated lipocalin as an indicator of acute kidney injury and inflammation in burned children

• Published in: Burns Vol. 40; no. 4; pp. 648 - 654
• Main Authors: Yavuz, Sevgi, Anarat, Ali, Acartürk, Sabri, Dalay, Ahmet Cemil, Kesiktaş, Erol, Yavuz, Metin, Acartürk, Tahsin Oğuz
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2014
• Subjects: Acute Kidney Injury - immunology; Acute Kidney Injury - metabolism; Acute-Phase Proteins - urine; Albuminuria; Biomarkers - blood; Biomarkers - urine; Blood Urea Nitrogen; Burn; Burns - immunology; Burns - metabolism; C-Reactive Protein - metabolism; Calcitonin - blood; Calcitonin Gene-Related Peptide; Case-Control Studies; Child; Child, Preschool; Cohort Studies; Creatinine - blood; Creatinine - urine; Critical Care; Female; Humans; Infant; Inflammation; Inflammation - metabolism; Injury Severity Score; Kidney injury; Lipocalin-2; Lipocalins - blood; Lipocalins - urine; Male; NGAL; Predictive Value of Tests; Prospective Studies; Protein Precursors - blood; Proto-Oncogene Proteins - blood; Proto-Oncogene Proteins - urine; Tissue damage; NGAL; Burn; Tissue damage; Inflammation; Kidney injury
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2013.09.004

Abstract Introduction Neutrophil gelatinase associated lipocalin (NGAL) is a novel predictor of acute kidney injury (AKI), which increases with inflammation. We aimed to assess whether serum NGAL (SNGAL) and urine NGAL (UNGAL) can predict AKI in burned children. Methods Patients were referred within the 12 h of burn to our center. Serum samples for SNGAL, C-reactive protein (CRP), procalcitonin (PCT) and urine for UNGAL, microalbumine (Umalb), creatinine (Ucr) were obtained at both admission and the 5th day after burn. Blood urea nitrogen (BUN) and serum creatinine (Scr) were examined daily. Results Twenty-two subjects were enrolled and six (27.2%) of them developed AKI within the 48 h of injury. Burn size and abbreviated burn severity index (ABSI) were significantly increased in patients with AKI. CRP, PCT, SNGAL and UNGAL levels at admission and day 5 were significantly higher in patients with AKI than in those without AKI and controls. Scr was not significant between AKI and non-AKI groups at hospital days 1 and 5. A SNGAL level of 315 ng/ml and a UNGAL level of 100 ng/ml were determined as predictive cut-off values of AKI at admission (sensitivity and specificity: 71.4%, 83.3% and 93.3%, 93.7%, respectively). SNGAL and UNGAL were positively correlated with CRP, PCT, ABSI and Umalb/Ucr. Conclusion SNGAL and UNGAL are good early predictors of AKI in children with severe burn. NGAL might reflect the severity of burn insult and also could be used as an indicator of inflammation in burn children.