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Neutrophil gelatinase‐associated lipocalin as a diagnostic marker of acute kidney injury in pre‐eclampsia
Author(s) -
Moyake Naledi,
Buchmann Eckhart,
Crowther Nigel J.
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13088
Subject(s) - medicine , lipocalin , eclampsia , acute kidney injury , biomarker , receiver operating characteristic , gastroenterology , area under the curve , urine , neutrophil gelatinase associated lipocalin , urinary system , urology , pregnancy , biochemistry , chemistry , genetics , biology
Aim Neutrophil gelatinase‐associated lipocalin (NGAL) is an emerging biomarker for early diagnosis of acute kidney injury (AKI). This study investigated the use of urinary NGAL as a marker of AKI in women with pre‐eclampsia. Methods Urine and serum samples were collected over 24 h from 78 healthy and 109 pre‐eclamptic women, with baseline samples taken at admission to the maternity unit; NGAL was assayed in serial urine samples. Results Baseline neutrophil gelatinase‐associated lipocalin did not differ significantly between women who were healthy, those with pre‐eclampsia, or with AKI ( P = 0.55 for trend). When the pre‐eclamptic group was divided into those with eclampsia (median, 60.5 ng/mL; IQR, 23.4–173 ng/mL; n = 19), uncomplicated pre‐eclampsia (median, 18.8 ng/mL; IQR, 7.5–52.8 ng/mL; n = 48; P < 0.05 vs eclampsia), imminent eclampsia (median, 30.7 ng/mL; IQR, 13.9–49.3 ng/mL; n = 22) and pre‐eclampsia with acute kidney injury (median, 60.3 ng/mL; IQR, 23.5–159 ng/mL, n = 14), however, NGAL level did differ. On multivariate regression analysis, the only significant correlate of NGAL level was the presence of eclampsia (beta = 0.22, P < 0.05). On receiver operating characteristic curve analysis, baseline NGAL did not discriminate between subjects with or without AKI (area under the curve, 0.61; 95%CI: 0.43–0.78; P = 0.12). Conclusion Neutrophil gelatinase‐associated lipocalin level at baseline and over a 24‐h period does not provide a suitable diagnostic test for AKI in pre‐eclamptic subjects.