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Urine neutrophil gelatinase-associated lipocalin is a marker of graft recovery after kidney transplantation
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Urine neutrophil gelatinase-associated lipocalin is a marker of graft recovery after kidney transplantation
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Journal Article
Urine neutrophil gelatinase-associated lipocalin is a marker of graft recovery after kidney transplantation
2011
Overview
Delayed graft function (DGF), especially long-lasting DGF, complicates kidney transplant outcome. Neutrophil gelatinase-associated lipocalin (NGAL) is an acute kidney injury marker; therefore, we tested whether urine NGAL could predict DGF, prolonged DGF (lasting over 14 days), or the quality of kidney function in transplant recipients without DGF (non-DGF). We collected urine samples from 176 recipients transplanted with deceased donor kidneys before and various days after transplantation. A total of 70 transplantations had DGF, of which 26 were prolonged. Patients who developed DGF had a significantly slower decrease in urinary NGAL compared with those without DGF, such that day 1 NGAL predicted DGF (area under the curve (AUC) 0.75) and predicted DGF in 15 of 112 cases with day 1 urine output over 1l (AUC 0.70) and in 19 of 86 cases with a day 1 decrease in creatinine over 50μmol/l (AUC 0.74). The urinary NGAL level on day 1 predicted prolonged DGF (AUC 0.75), which had significantly worse 1-year graft survival (73%), compared with shorter DGF (100%). In non-DGF, high day 3 NGAL (greater than the mean) was associated with significantly worse kidney function at 3 weeks compared with low NGAL, but not at 3 months and 1 year. NGAL did not correlate with long-term function in DGF. Hence, day 1 urinary NGAL predicted DGF even when it was not clinically expected early on, and importantly, it predicted prolonged DGF that led to worse graft survival.
Publisher
Elsevier Inc,Nature Publishing Group,Elsevier Limited
Subject
/ Adult
/ Aged
/ Biological and medical sciences
/ Child
/ Delayed Graft Function - diagnosis
/ Delayed Graft Function - physiopathology
/ Delayed Graft Function - urine
/ Female
/ Humans
/ Kidney Transplantation - physiology
/ Male
/ Nephrology. Urinary tract diseases
/ NGAL
