Neutrophil gelatinase-associated lipocalin reflects the severity of renal impairment in subjects affected by chronic kidney disease
Neutrophil gelatinase-associated lipocalin reflects the severity of renal impairment in subjects affected by chronic kidney disease
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DOI：
10.1159/000143726
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发表时间：
2008-01-01
影响因子：
2.8
通讯作者：
Buemi, Michele
中科院分区：
文献类型：
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作者：
Bolignano, Davide;Lacquaniti, Antonio;Buemi, Michele
中性粒细胞明胶酶相关脂钙蛋白（NGAL）是肾小管细胞在受到有害刺激后释放的一种25 kda的小蛋白。它代表了急性肾损伤（AKI）诊断领域最有前途的未来生物标志物之一，因为NGAL水平的升高是AKI短期发病的良好预测指标，特别是预测血清肌酐的升高。然而，最近的研究也表明NGAL在慢性肾脏疾病（CKD）中可能起作用。因此，我们在CKD患者队列中评估了血清（sNGAL）和尿液NGAL (uNGAL)，以验证其与肾功能损害严重程度的关系。与对照组相比，CKD患者的sNGAL、uNGAL和该蛋白的部分排泄明显增加。此外，sNGAL和uNGAL均与血清肌酐相关，并与残余肾小球滤过率（GFR）呈负相关：最后一种关系被发现比GFR和血清肌酐之间的关系更密切。多变量模型验证了这些相关性是独立的，证实在这些患者中，NGAL比血清肌酐更能预测GFR。这些结果证实了NGAL在临床肾脏病学中是一个重要的生物标志物，并将该蛋白在肾小管适应肾损伤中的病理生理作用扩展到CKD。版权所有2008 S. Karger AG，巴塞尔
Neutrophil gelatinase-associated lipocalin (NGAL) is a small 25-kDa protein released from kidney tubular cells after harmful stimuli. It represents one of the most promising future biomarkers in the diagnostic field of acute kidney injury (AKI), as the increase in NGAL levels is a good predictor of a brief-term onset of AKI, notably anticipating the resulting increase in serum creatinine. However, recent studies also suggest a possible role for NGAL in chronic kidney disease (CKD). For this reason we evaluated serum (sNGAL) and urinary NGAL (uNGAL) in a cohort of CKD patients in order to verify the relationship with the severity of renal impairment. In CKD patients sNGAL, uNGAL and the fractional excretion of this protein were notably increased as compared to controls. Furthermore both sNGAL and uNGAL were correlated with serum creatinine and, inversely, with residual glomerular filtration rate (GFR): this last relationship was found to be even closer than that found between GFR and serum creatinine. Multivariate models validate these correlations as independent, confirming that in these patients NGAL is a better predictor of GFR than serum creatinine. The results confirm NGAL as an important biomarker in clinical nephrology, extending to CKD the pathophysiological role of this protein in tubular adaptations to renal damage. Copyright (C) 2008 S. Karger AG, Basel.