Urine neutrophil gelatinase-associated lipocalin in septic patients with and without acute kidney injury

Introduction: Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a rapidly emerging biomarker for early detection of acute kidney injury (AKI). We aimed to investigate the prevalence and prognostic value of the early uNGAL in patients with AKI induced by sepsis. Methods: In this prospective cohort study, we analyzed the case records of 126 septic patients with and without AKI and evaluated the uNGAL for early prediction and risk stratification of septic patients with AKI. Results: Of 126 patients analyzed, 58 (46%) developed septic AKI. Men comprised more than half (68%) of the sample population, the mean age (SD) was 57 years. The prognostic accuracy of uNGAL, as quantified by the area under the receiver-operating-characteristic curve (AU-ROC), was highest with peak uNGAL (AU-ROC: 0.86; 95% CI: 0.81-0.93), as compared with the admission uNGAL (AU-ROC: 0.81; 95% CI: 0.73-0.89). The peak uNGAL correlated with the levels of peak blood urea nitrogen (r = 0.674) and serum creatinine (r = 0.608), the length of hospital stay (r = 0.602) and weakly correlated with the number of hemodialysis sessions that each patient received during hospital stay (r = 0.405). By multivariate analysis, increased peak uNGAL remained independently associated with the development of septic AKI (odds ratio: 32.12; 95% CI: 6.21-90.37; p < 0.0001). Conclusions: uNGAL is independently associated with subsequent AKI among patients with sepsis.