Plasma neutrophil gelatinase-associated lipocalin as a potential predictor of adverse renal outcomes in immunoglobulin A nephropathy.
10.3904/kjim.2015.30.3.345
- Author:
Ga Young PARK
1
;
Chung Hoon YU
;
Jun Seop KIM
;
Yun Jeong KANG
;
Owen KWON
;
Ji Young CHOI
;
Jang Hee CHO
;
Chan Duck KIM
;
Yong Lim KIM
;
Sun Hee PARK
Author Information
1. Department of Internal Medicine, Kyungpook National University School of Medicine and Clinical Research Center for End Stage Renal Disease, Daegu, Korea. sh-park@knu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Glomerulonephritis, IGA;
Neutrophil gelatinase-associated lipocalin;
Prognosis;
Renal insufficiency, chronic
- MeSH:
Acute-Phase Proteins;
Adolescent;
Adult;
Aged;
Biomarkers/blood;
Biopsy;
Chi-Square Distribution;
Creatinine/blood;
Disease Progression;
Enzyme-Linked Immunosorbent Assay;
Female;
Glomerular Filtration Rate;
Glomerulonephritis, IGA/*blood/complications/pathology/physiopathology;
Humans;
Kidney/*metabolism/pathology/physiopathology;
Linear Models;
Lipocalins/*blood;
Male;
Middle Aged;
Multivariate Analysis;
Predictive Value of Tests;
Prognosis;
Proportional Hazards Models;
Proto-Oncogene Proteins/*blood;
Renal Insufficiency, Chronic/blood/etiology;
Republic of Korea;
Retrospective Studies;
Risk Factors;
Time Factors;
Young Adult
- From:The Korean Journal of Internal Medicine
2015;30(3):345-353
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Neutrophil gelatinase-associated lipocalin (NGAL) is a well-known biomarker of acute kidney injury. We evaluated the value of plasma NGAL (pNGAL) as an independent predictor of prognosis in immunoglobulin A nephropathy (IgAN). METHODS: In total, 91 patients with biopsy-proven IgAN at a single center were evaluated. pNGAL was measured using a commercial enzyme-linked immunosorbent assay kit (R&D Systems). Adverse renal outcome was defined as chronic kidney disease (CKD) stage 3 or above at the last follow-up. Pearson correlation coefficient and Cox regression were used for analyses. RESULTS: The mean age of all patients (male:female, 48:43) was 35 years (range, 18 to 77). pNGAL ranged between 21.68 and 446.40 ng/mL (median, 123.97) and showed a correlation with age (r = 0.332, p = 0.001), creatinine (r = 0.336, p = 0.001), estimated glomerular filtration rate (r = -0.397, p < 0.001), uric acid (r = 0.289, p = 0.006), and the protein-to-creatinine ratio (r = 0.288, p = 0.006). During a mean follow-up period of 37.6 months, 11 patients (12.1%) had CKD stage 3 or above. In a multivariate Cox regression model, hypertension (hazard ratio [HR], 8.779; 95% confidence interval [CI], 1.526 to 50.496; p = 0.015), proteinuria > 1 g/day (HR, 5.184; 95% CI, 1.124 to 23.921; p = 0.035), and pNGAL (HR, 1.012; 95% CI, 1.003 to 1.022; p = 0.013) were independent predictors associated with adverse renal outcome. CONCLUSIONS: pNGAL showed strong correlations with other clinical prognostic factors and was also an independent predictor of adverse renal outcome. We suggest pNGAL as a potential predictor for prognosis in IgAN, while further studies are needed to confirm the clinical value.
