THE DIAGNOSTIC PERFORMANCE OF PLASMA NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN IN DETECTING ACUTE KIDNEY INJURY (AKI) IN ADULT CRITICALLY ILL PATIENTS COMPARED WITH CREATININE IN BLOOD

Amina Ali Musallam AL-Amri* and Dr. Hassan Sadek

ABSTRACT

Background: Acute Kidney Injury (AKI) is prevalent among critical illnesses and related with over 50% death. In current practice the detection of AKI is based on elevation of creatinine ≥ 50% from the baseline (RIFLE/AKIN criteria). Although creatinine in blood is influenced by factors as age and muscles mass. Thus new biomarker was reported to identify AKI in critical ill patients in order to prevent AKI and reduce the mortality by AKI. This was neutrophil gelatinase-assossiated lipocalin (NGAL). Aim: To assess the diagnostic performance of plasma NGAL (pNGAL) in detecting AKI in adult critically ill patients without AKI at the Intensive Care Unit (ICU) entry compared with creatinine in blood (serum or plasma). Method: Electronic search through Glasgow Caledonian University (GCU) used AMED, CINHAL and Medline databases (EBSCO). The used keywords were: (Critical ill patients or critical illness or critical care) and (NGAL or neutrophil gelatinas-associated lipocalin). The scanning for eligibility was initially throughout the title then reading the abstract to select the articles that met the inclusion criteria. Finally, the studies were assessed for the quality by using Scottish Intercollegiate Guidelines (SIGN) diagnosis checklist. Results: The final search's results were thirty two articles. Eight out of 32 articles were scanned for eligibility. Only six articles were included. The significant diagnostic performance of pNGAL compared with creatinine in blood in each study was: Constantin et al (2010) P = 0.956; Cruz et al (2010) P = 0.0001; De Geus et al (2011) P ˂ 0.001; Kokkoris et al (2012) P = 0.001; Aydogdu et al (2013) P = 0.44 and Pickring & Endre (2013) P = 0.06. Conclusion: pNGAL is a good test to diagnose AKI. Despite that, large multicentre studies are recommended to generalize the findings.

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