Serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting worsening renal function in acute decompensated heart failure.
Serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting worsening renal function in acute decompensated heart failure.
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DOI：
10.1016/j.cardfail.2009.07.003
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发表时间：
2010-01
影响因子：
6
通讯作者：
Tang, W. H. Wilson
中科院分区：
文献类型：
--
作者：
Aghel, Arash;Shrestha, Kevin;Mullens, Wilfried;Borowski, Allen;Tang, W. H. Wilson
肾功能恶化（WRF，定义为肌酐升高≥0.3 mg/dL）在急性失代偿性心力衰竭（ADHF）的情况下经常发生，并且强烈预示不良临床结局。中性粒细胞明胶酶相关脂质运载蛋白（NGAL）由肾单位在肾小管上皮损伤时产生，是急性肾小管损伤的早期标志物。我们试图确定ADHF患者入院时血清NGAL水平与WRF之间的关系。
我们测量了91例因ADHF入院患者的血清NGAL水平。由独立医生判定患者在随后5天的住院治疗期间是否发生WRF。在我们的研究队列中（68%为男性，平均年龄61±15岁，平均左心室射血分数31±14%），入院时血清NGAL水平中位数为165 ng/mL（四分位间距[IQR]108 - 235 ng/mL）。35例患者（38%）在5天的随访期内发生了WRF。发生WRF的患者与未发生WRF的患者相比，入院时血清NGAL水平中位数显著更高（194[IQR 150 - 292]ng/mL对比128[IQR 97 - 214]ng/mL，P = 0.001）。入院时血清NGAL水平高与发生WRF的可能性更大相关（比值比：1.92，95%置信区间1.23 - 3.12，P = 0.004）。特别是，入院时NGAL≥140 ng/mL发生WRF的风险增加7.4倍，敏感性和特异性分别为86%和54%。
ADHF入院患者中，入院时血清NGAL水平升高与随后发生WRF的风险增加相关。
The development of worsening renal function (WRF, defined as creatinine rise ≥0.3 mg/dL) occurs frequently in the setting of acute decompensated heart failure (ADHF) and strongly predicts adverse clinical outcomes. Neutrophil gelatinase–associated lipocalin (NGAL) is produced by the nephron in response to tubular epithelial damage and serves as an early marker for acute renal tubular injury. We sought to determine the relationship between admission serum NGAL levels and WRF in the setting of ADHF. We measured serum NGAL levels in 91 patients admitted to the hospital with ADHF. Patients were adjudicated by independent physician into those that did or did not develop WRF over the ensuing 5 days of in-hospital treatment. In our study cohort (68% male, mean age 61 ± 15 years, mean left ventricular ejection fraction 31 ± 14%), median admission serum NGAL level was 165 ng/mL (interquartile range [IQR] 108–235 ng/mL). Thirty-five patients (38%) developed WRF within the 5-day follow-up. Patients who developed WRF versus those without WRF had significantly higher median admission serum NGAL levels (194 [IQR 150–292] ng/mL vs. 128 [IQR 97–214] ng/mL, P = .001). High serum NGAL levels at admission were associated with greater likelihood of developing WRF (odds ratio: 1.92, 95% confidence interval 1.23–3.12, P = .004). In particular, admission NGAL ≥140 ng/mL had a 7.4-fold increase in risk of developing WRF, with a sensitivity and specificity of 86% and 54%, respectively. The presence of elevated admission serum NGAL levels is associated with heightened risk of subsequent development of WRF in patients admitted with ADHF.
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影响因子：
39.2
作者：
Nickolas, Thomas L.;O'Rourke, Matthew J.;Barasch, Jonathan
通讯作者：
Barasch, Jonathan
影响因子：
168.9
作者：
Mishra, J;Dent, C;Devarajan, P
通讯作者：
Devarajan, P
DOI：
10.1097/01.asn.0000088027.54400.c6
发表时间：
2003-10-01
影响因子：
13.6
作者：
Mishra, J;Ma, Q;Devarajan, P
通讯作者：
Devarajan, P
影响因子：
8.8
作者：
Wagener, Gebhard;Jan, Michael;Lee, H. Thomas
通讯作者：
Lee, H. Thomas
影响因子：
4.2
作者：
Bachorzewska-Gajewska, H.;Malyszko, J.;Dobrzycki, S.
通讯作者：
Dobrzycki, S.