Open AccessEvaluation of Neutrophil Gelatinase‐Associated Lipocalin as a Marker of Kidney Injury in Dogs
Author(s) -
Segev G.,
Palm C.,
LeRoy B.,
Cowgill L.D.,
Westropp J.L.
Publication year - 2013
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.12180
Subject(s) - medicine , creatinine , acute kidney injury , lipocalin , kidney disease , urinary system , gastroenterology , biomarker , urology , biochemistry , chemistry
Background Acute kidney injury ( AKI ) is a common and often fatal disorder in dogs. Hypothesis Urine neutrophil gelatinase‐associated lipocalin ( NGAL )/creatinine ratio is a sensitive and specific biomarker of AKI in dogs. Animals Ninety‐four dogs. Methods Prospective study. Dogs were classified as follows: (1) healthy dogs, (2) dogs with lower urinary tract disorders, (3) dogs with chronic kidney disease ( CKD ), (4) dogs with azotemic International Renal Interest Society ( IRIS ) AKI Grades II–V, and (5) dogs with IRIS AKI Grade I (nonazotemic). Urinary NGAL was quantitated in each dog using an ELISA assay and concentrations were expressed as a ratio to urinary creatinine concentration from the same specimen, and designated the urinary NGAL /creatinine ratio ( UNCR ). Results There was a significant difference in UNCR among the study groups ( P < .001). Both the azotemic and nonazotemic AKI groups had higher UNCR when compared with all other groups ( P < .001 for all pairs). There was a statistically significant difference in UNCR between dogs diagnosed with CKD compared with dogs with lower urinary tract diseases ( P = .005) as well as between dogs with CKD and healthy dogs ( P = .001). Receiver operator characteristics ( ROC ) analysis of UNCR as an indicator of azotemic and nonazotemic AKI had an area under the ROC curve of 0.94 and 0.96, respectively. Conclusions and Clinical Relevance NGAL /creatinine ratio is a sensitive and specific marker of AKI . It can be used to screen patients at risk for AKI and can be utilized to diagnose milder forms of AKI potentially earlier in the course of the disease.