Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis

Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis

Introduction: Sepsis is the leading cause of ICU admission. About 60% of patients with severe sepsis had acute kidney injury (AKI). To date, plasma Neutrophil-Gelatinase Associated Lipocalin (NGAL) is the most promising biomarker for AKI, however it is also increased with inflammation and infection....

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Main Authors: Md Ralib, Azrina, Abdullah, Nor Zamzila, Mohamed, Rozilah @ Abdul Hadi, Mat Nor, Mohd. Basri
Format: Conference or Workshop Item
Language:English
Published: 2015
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/43427/
http://irep.iium.edu.my/43427/1/MSA_NGAL_AZRINA.pdf
id iium-43427
recordtype eprints
spelling iium-434272018-10-01T06:59:32Z http://irep.iium.edu.my/43427/ Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis Md Ralib, Azrina Abdullah, Nor Zamzila Mohamed, Rozilah @ Abdul Hadi Mat Nor, Mohd. Basri R Medicine (General) Introduction: Sepsis is the leading cause of ICU admission. About 60% of patients with severe sepsis had acute kidney injury (AKI). To date, plasma Neutrophil-Gelatinase Associated Lipocalin (NGAL) is the most promising biomarker for AKI, however it is also increased with inflammation and infection. Objectives: We aim to evaluate the utility of NGAL, Procalcitonin (PCT) and Interleukin-6 (IL-6) for AKI and sepsis. Methods: This is an interim analysis of a prospective observational study of adult ICU patients with systemic inflammatory response syndroem (SIRS). PCT was measured using BRAHMS Kryptor compact assay, NGAL using TriageMeter, IL-6 using ELISA technique, and creatinine using Olympus AU2700TM analyser. Patients were classified according to the occurrence of AKI and sepsis. Results: Of the 115 patients, 62 (54%) had AKI, of which 43 (69%) had sepsis, and in 19 (31%) non-infectious SIRS. NGAL and PCT were higher in patients with AKI-SIRS compared to No AKI-SIRS (p=0.001 and p=0.02, respectively), and in AKI-Sepsis compared to No AKI-Sepsis (p<0.0001 and p=0.001, respectively). However, there were no differences in plasma IL-6. NGAL had the highest AUC in diagnosing AKI (0.78 (0.69 to 0.86)). The AUC of NGAL in diagnosing AKI was 0.80 (0.66 to 0.93) in SIRS, and 0.76 (0.65 to 0.87) in sepsis. The optimal cut-off point was 84 ng/ml in SIRS and 256 ng/ml in sepsis. Addition of NGAL to the reference model, which includes age, weight, and SAPSII score, showed the largest improvement in risk assessment; with total IDI of 0.09 (0.02 to 0.28). Conclusions: AKI is more common in sepsis patients. Of the biomarkers measured, NGAL had the highest diagnostic performance for AKI. The optimal cut-off point for diagnosing AKI in sepsis was higher than in non-infectious SIRS. The addition of NGAL improved the clinical model incorporating age, illness severity and weight in diagnosing AKI. 2015 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/43427/1/MSA_NGAL_AZRINA.pdf Md Ralib, Azrina and Abdullah, Nor Zamzila and Mohamed, Rozilah @ Abdul Hadi and Mat Nor, Mohd. Basri (2015) Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis. In: Malaysian Society of Anaesthesiologists & College of Anaesthesiologists Annual Scientific Congress 2015 & 13th Asian Society of Paediatric Anaesthesiologists Congress, 11-14 June 2015, Hotel Equatorial Penang.
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Md Ralib, Azrina
Abdullah, Nor Zamzila
Mohamed, Rozilah @ Abdul Hadi
Mat Nor, Mohd. Basri
Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis
description Introduction: Sepsis is the leading cause of ICU admission. About 60% of patients with severe sepsis had acute kidney injury (AKI). To date, plasma Neutrophil-Gelatinase Associated Lipocalin (NGAL) is the most promising biomarker for AKI, however it is also increased with inflammation and infection. Objectives: We aim to evaluate the utility of NGAL, Procalcitonin (PCT) and Interleukin-6 (IL-6) for AKI and sepsis. Methods: This is an interim analysis of a prospective observational study of adult ICU patients with systemic inflammatory response syndroem (SIRS). PCT was measured using BRAHMS Kryptor compact assay, NGAL using TriageMeter, IL-6 using ELISA technique, and creatinine using Olympus AU2700TM analyser. Patients were classified according to the occurrence of AKI and sepsis. Results: Of the 115 patients, 62 (54%) had AKI, of which 43 (69%) had sepsis, and in 19 (31%) non-infectious SIRS. NGAL and PCT were higher in patients with AKI-SIRS compared to No AKI-SIRS (p=0.001 and p=0.02, respectively), and in AKI-Sepsis compared to No AKI-Sepsis (p<0.0001 and p=0.001, respectively). However, there were no differences in plasma IL-6. NGAL had the highest AUC in diagnosing AKI (0.78 (0.69 to 0.86)). The AUC of NGAL in diagnosing AKI was 0.80 (0.66 to 0.93) in SIRS, and 0.76 (0.65 to 0.87) in sepsis. The optimal cut-off point was 84 ng/ml in SIRS and 256 ng/ml in sepsis. Addition of NGAL to the reference model, which includes age, weight, and SAPSII score, showed the largest improvement in risk assessment; with total IDI of 0.09 (0.02 to 0.28). Conclusions: AKI is more common in sepsis patients. Of the biomarkers measured, NGAL had the highest diagnostic performance for AKI. The optimal cut-off point for diagnosing AKI in sepsis was higher than in non-infectious SIRS. The addition of NGAL improved the clinical model incorporating age, illness severity and weight in diagnosing AKI.
format Conference or Workshop Item
author Md Ralib, Azrina
Abdullah, Nor Zamzila
Mohamed, Rozilah @ Abdul Hadi
Mat Nor, Mohd. Basri
author_facet Md Ralib, Azrina
Abdullah, Nor Zamzila
Mohamed, Rozilah @ Abdul Hadi
Mat Nor, Mohd. Basri
author_sort Md Ralib, Azrina
title Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis
title_short Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis
title_full Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis
title_fullStr Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis
title_full_unstemmed Plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis
title_sort plasma neutrophil gelatinase-associated lipocalin best diagnosed acute kidney injury in patients with systemic inflammatory response syndrome and sepsis
publishDate 2015
url http://irep.iium.edu.my/43427/
http://irep.iium.edu.my/43427/1/MSA_NGAL_AZRINA.pdf
first_indexed 2023-09-18T21:01:52Z
last_indexed 2023-09-18T21:01:52Z
_version_ 1777410677502115840

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