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Marker of Renal Injury May Aid in Diagnosis

NGAL higher in patients with HIV-associated nephropathy and acute kidney injury

FRIDAY, July 24 (HealthDay News) -- Urinary levels of neutrophil gelatinase-associated lipocalin (NGAL), a marker of renal tubular injury, are higher in patients with HIV-associated nephropathy (HIVAN) and in critically ill patients who develop acute kidney injury, according to two studies published online July 23 in the Journal of the American Society of Nephrology.

In the first study, Neal Paragas, from Columbia University in New York City, and colleagues examined the expression of NGAL in patients with HIVAN, in HIV-positive and -negative patients with other forms of chronic kidney disease, and in a mouse model of HIVAN. They found that urinary NGAL expression was much higher in patients with HIVAN and in the mouse model and did not correlate with proteinuria.

In the second study, Edward D. Siew, M.D., from Vanderbilt University Medical Center in Nashville, Tenn., and colleagues examined the expression of urinary NGAL in 451 critically ill adults. They found that urinary NGAL was higher at baseline in patients who developed acute kidney injury and was independently associated with acute kidney injury, though it only marginally improved prediction compared with conventional clinical risk predictors alone.

"In summary, we found urinary NGAL to be independently associated with and exhibit moderate discrimination for the detection of subsequent acute kidney injury within a heterogeneous intensive care unit population," Siew and colleagues conclude.

Abstract - Paragas
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Abstract - Siew
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