engleski

VALUE OF URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AS BIOMARKER OF ACUTE KIDNEY INJURY AFTER KIDNEY TRANSPLANTATION: A PILOT STUDY

Background. Urinary neutrophil gelatinase- associated lipocalin (NGAL) is produced in the distal nephron and its synthesis is upregulated in response to kidney injury. The purpose of this pilot study was to evaluate the use of urinary NGAL the biomarker of acute kidney injury (AKI) in kidney transplant recepients. Methods. Urinary NGAL was measured by chemiluminescent microparticle immunoassay –CMIA ( Architect analyzer ; Abbott Diagnostics). Verification of performance for precision was performed based on guidance from the Clinical and Laboratory Standards Institute (CLSI) Document EP15-A2. In the low concentration level the obtained within- laboratory precision was 12.2% and 1.8% in the high concentration level, respectively. Diagnosis of AKI was based on renal biopsy as a gold standard for establishing the diagnosis. In this pilot study 61 protocol (at 1, 3, 6 and 12 months) or indication kidney biopsies were performed in 37 adult patients after kidney transplantation. Results. Acute kidney injury was diagnosed in 33 biopsies while in 28 biopsies did not. Highly increased urine NGAL concentrations (79.7-486.8 µg/L) were found in 21% of cases with AKI, moderately increased concentrations (above 10 µg/L) in 58% and below 10 µg/L in 21% of cases, respectively. There were no association between urinary NGAL concentrations (3.2- 154.0 µg/L) and tubular atrophy and interstitial fibrosis in kidney transplant recipients. Conclusions. NGAL is a biomarker of AKI in kidney transplant recipients. However more data are needed to determine whetherthe concentration measurement of urinary NGAL could lead to accurate noninvasive diagnosing of acute kidney injury after kidney transplantation.

Urinary neutrophil gelatinase-associated lipocalin (NGAL); acute kidney injury; transplant recipients.

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