Serum neutrophil gelatinase-associated lipocalin (NGAL) in patients with shiga toxin mediated haemolytic uraemic syndrome (STEC-HUS)
Lukasz A, Beneke J, Menne J, Vetter F, Schmidt BMW, Schiffer M, Haller H, Kuempers P, Kielstein JT (2013)
Publication Type: Journal article
Publication year: 2013
Journal
Book Volume: 111
Pages Range: 365-372
Journal Issue: 2
DOI: 10.1160/TH13-05-0387
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) is an increasingly used biomarker for acute kidney injury (AKI). Its utility in adult patients with AKI caused by Shiga toxin producing Escherichia coli infection (STEC)-associated haemolytic-uraemic syndrome (HUS), remains unknown. We aimed to evaluate the prognostic value of serum NGAL admission levels for the need of renal replacement therapy (RRT) in STEC-HUS patients. Baseline serum NGAL was determined by ELISA in 39 patients with STEC O104:H4 infection cared for at Hannover Medical School during the outbreak in Germany through May-July 2011. Patients with HUS had significant higher NGAL levels than healthy controls (379 [248 - 540] vs 39.0 [37.5-45] ng/ml, p < 0.0001). During clinical course, 24 patients required RRT at a median of five days after admission. NGAL admission levels were higher in patients requiring RRT (476 (344-639) ng/ml) compared to patients not requiring RRT (257 (196-426) ng/ml; p < 0.001). Unadjusted and adjusted logistic regression analyses identified NGAL as an independent predictor for need of RRT. In a combined model, a joint NGAL/AKIN classification approach improved the predictive accuracy for need of RRT over either marker alone. The combined categorical cut-off point defined by NGAL ≥ 330 ng/ml and presence of AKI (AKIN ≥ I) on admission correctly identified 20 of 24 patients requiring RRT (odds ratio 20, sensitivity 83%, specificity 80%, negative predictive value 75%, positive predictive value 87%). NGAL may serve as an adjunctive tool to improve risk prediction in patients with STEC-HUS. © Schattauer 2014.
Authors with CRIS profile
Involved external institutions
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Universitätsklinikum Münster
Germany (DE)
Germany (DE)
Universitätsklinikum Münster
Germany (DE)
How to cite
APA:
Lukasz, A., Beneke, J., Menne, J., Vetter, F., Schmidt, B.M.W., Schiffer, M.,... Kielstein, J.T. (2013). Serum neutrophil gelatinase-associated lipocalin (NGAL) in patients with shiga toxin mediated haemolytic uraemic syndrome (STEC-HUS). Thrombosis and Haemostasis, 111(2), 365-372. https://doi.org/10.1160/TH13-05-0387
MLA:
Lukasz, Alexander, et al. "Serum neutrophil gelatinase-associated lipocalin (NGAL) in patients with shiga toxin mediated haemolytic uraemic syndrome (STEC-HUS)." Thrombosis and Haemostasis 111.2 (2013): 365-372.
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