Open AccessSerum Neutrophil Gelatinase‐Associated Lipocalin and Interleukin‐18 as Predictive Biomarkers for Delayed Graft Function After Kidney Transplantation
Author(s) -
Lee Eun Young,
Kim Myoung Soo,
Park Yongjung,
Kim HyonSuk
Publication year - 2012
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.21520
Subject(s) - creatinine , medicine , transplantation , kidney transplantation , lipocalin , urology , renal function , receiver operating characteristic , area under the curve , kidney , gastroenterology , biomarker , endocrinology , chemistry , biochemistry
Background Early biomarkers for acute kidney injury after kidney transplantation have been studied because delayed graft function ( DGF ) is associated with increased risk of acute rejection and graft loss. We investigated the usefulness of serum neutrophil gelatinase‐associated lipocalin ( NGAL ) and interleukin‐18 ( IL ‐18) for the prediction of DGF after kidney transplantation. Materials and Methods Fifty‐nine kidney transplant recipients were included and they were separated into DGF and immediate graft function ( IGF ) groups. Serum samples were collected on the preoperative day as well as days 1, 5, and 14 after the transplantation, and assayed for NGAL and IL ‐18. Results After transplantation, serum levels of NGAL were significantly higher at any time in patients with DGF compared to those with IGF . Serum concentrations of IL ‐18 were not different between both groups. The receiver operating characteristics (ROC) ‐area under the curve ( AUC ) values of NGAL , IL ‐18, and creatinine on day 1 for the discrimination of DGF from IGF were 0.86, 0.63, and 0.65. On POD 1, the sensitivities of NGAL and creatinine were respectively 78.6%, and 50.0% at 77.8% specificity, and the AUC values for any combinations including NGAL and that for NGAL alone were higher than that of creatinine. Conclusion Serum NGAL is an early and sensitive marker of graft dysfunction in kidney transplantation, while serum IL ‐18 showed limited values. J. Clin. Lab. Anal. 26:286‐294, 2012. © 2012 Wiley Periodicals, Inc.