Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Progression of Chronic Kidney Disease
Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Progression of Chronic Kidney Disease
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DOI：
10.2215/cjn.03530708
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发表时间：
2009-02-01
影响因子：
9.8
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
背景和目标：慢性肾脏病（CKD）最近已成为流行病，成为一个令人不安的新的发病原因，特别是如果它进展到终末期（ESRD）。作者旨在评估中性粒细胞明胶酶相关脂质运载蛋白（NGAL），一种新的急性肾损伤特异性生物标志物，是否可以预测CKD的进展。设计，设置，参与者和测量：在96例患者的队列中评估血清和尿液NGAL水平，以及一系列推定的进展因素（平均年龄：57 +/- 16岁）受各种病因的非终末期CKD（eGFR >= 15 ml/min/1.73 m（2））影响。CKD的进展，评估为基线血清肌酐和/或ESRD的发病增加一倍，在随访期间进行了评估。结果：在基线时，血清和尿NGAL呈负相关，独立，密切相关的eGFR。中位随访18.5个月（范围1.01 - 20）后，31例患者（32%）达到复合终点。基线时，这些患者年龄明显较大，血清肌酸酐、磷酸钙产物、C反应蛋白、纤维蛋白原、每日蛋白尿和NGAL水平升高，而eGFR值明显较低。单因素多因素考克斯比例风险回归分析表明，尿NGAL和sNGAL预测CKD进展独立于其他潜在的混杂因素，包括eGFR和age.Conclusion：在CKD患者中，NGAL密切反映了肾功能损害的实体，并代表了一个强大的和独立的风险标志物CKD进展。
Background and objectives: Chronic kidney disease (CKD) has recently assumed epidemic proportion, becoming a troubling emerging cause of morbidity, especially if it progresses to terminal stage (ESRD). The authors aimed to evaluate whether neutrophil gelatinase-associated lipocalin (NGAL), a novel specific biomarker of acute kidney injury, could predict the progression of CKD.Design, setting, participants, & measurements: Serum and urinary NGAL levels, together with a series of putative progression factors, were evaluated in a cohort of 96 patients (mean age: 57 +/- 16 years) affected by nonterminal CKD (eGFR >= 15 ml/min/1.73 m(2)) of various etiology. Progression of CKD, assessed as doubling of baseline serum creatinine and/or onset of ESRD, was evaluated during follow-up.Results: At baseline, both serum and urinary NGAL were inversely, independently, and closely related to eGFR. After a median follow-up of 18.5 mo (range 1.01 to 20), 31 patients (32%) reached the composite endpoint. At baseline, these patients were significantly older and showed increased serum creatinine, calcium-phosphate product, C-reactive protein, fibrinogen, daily proteinuria, and NGAL levels, whereas eGFR values were significantly lower. Univariate followed by multivariate Cox proportional hazard regression analysis showed that urinary NGAL and sNGAL predicted CKD progression independently of other potential confounders, including eGFR and age.Conclusion: In patients with CKD, NGAL closely reflects the entity of renal impairment and represents a strong and independent risk marker for progression of CKD.