plasma neutrophil gelatinase-associated lipocalin for the prediction of acute kidney injury in acute heart failure等离子体中性粒细胞gelatinase-associated lipocalin预测急性肾损伤的急性心力衰竭.pdfVIP

Breidthardt et al. Critical Care 2012, 16:R2 /content/16/1/R2 RESEARCH Open Access Plasma neutrophil gelatinase-associated lipocalin for the prediction of acute kidney injury in acute heart failure 1,2,4* 1 1 1,3 1 1 Tobias Breidthardt , Thenral Socrates , Beatrice Drexler , Markus Noveanu , Corinna Heinisch , Nisha Arenja , 1,2,5 1 1,3 1,3 1 2 Theresia Klima , Christina Züsli , Tobias Reichlin , Mihael Potocki , Raphael Twerenbold , Jürg Steiger and Christian Mueller1,3 Abstract Introduction: The accurate prediction of acute kidney injury (AKI) in patients with acute heart failure (AHF) is an unmet clinical need. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel sensitive and specific marker of AKI. Methods: A total of 207 consecutive patients presenting to the emergency department with AHF were enrolled. Plasma NGAL was measured in a blinded fashion at presentation and serially thereafter. The potential of plasma NGAL levels to predict AKI was assessed as the primary endpoint. We defined AKI according to the AKI Network classification. Results: Overall 60 patients (29%) experienced AKI. These patients were more likely to suffer from pre-existing chronic cardiac or kidney disease. At presentation, creatinine (median 140 (interquartile range (IQR), 91 to 203) umol/L versus 97 (76 to 132) umol/L, P 0.01) and NGAL (114.5 (IQR, 67.1 to 201.5) ng/ml versus 74.5 (60 to 113.9) ng/ml, P 0.01) levels were significantly higher in AKI compared to non-AKI patients. The prognostic accuracy for measurements obtain