engleski

SENSITIVITY AND SPECIFICITY OF NGAL IN ACUTE PYELONEPHRITIS

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a small protein expressed in renal tubules where it is considerably induced in ishemic or nephrotoxic injury. A single urine NGAL measurement is proposed test for distinguish acute kidney injury. However, single urine can sometimes be concentrated or diluted, which can influence results of measurements. Materials and methods: We have analyzed 90 children under 5 years of age, which were admitted to the Pediatric Clinic. 62 of them had acute pyelonephritis, while 28, who represented controls, had cystitis or fever of other etiology. Routine laboratory analyses (CBC, CRP and urine analysis), urine culture, kidney ultrasound and static scintigraphy were also done. Urine NGAL was measured using CMIA method (ARHITECT i1000, ABBOT). We have compared single NGAL concentrations with mg NGAL/g creatinine in same patient. Statistical calculation was performed using Mann-Whitney rank sum test and ROC analyses. Results: At a cut-off value of 29.1 ng/ml NGAL, sensitivity and specificity for detecting acute pyelonephritis was 0.964 (95% CI, 0.901 to 0.992), while at cut-off value of 120.1 mg NGAL/g creatinine sensitivity and specificity was 0.988 (95% CI, 0.938 to 1.000). Mann- Whitney rank sum test also showed significant difference in median values between the two groups for both measurements (P < 0.001). Conclusion: Although the values of NGAL / g creatinine were a bit superior, there is no statistical significant difference between measurements.

NGAL ; acute pyelonephritis

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