Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New lab test helps predict kidney damage

27.07.2009
'Urine NGAL' gives clues to kidney injury in ICU patients and HIV-related kidney disease

Acute kidney injury (AKI) is a frequent complication in patients in intensive care. A new laboratory test called urine neutrophil gelatinase associated lipocalin (NGAL) helps predict if patients will develop acute kidney injury, reports an upcoming study in the Journal of the American Society of Nephrology (JASN).

"As a stand-alone marker, urine NGAL performed moderately well in predicting ongoing and subsequent AKI," comments T. Alp Ikizler, MD (Vanderbilt University).

Another study, also in JASN, indicates that urine NGAL may also help in diagnosing HIV-related kidney disease affecting African Americans and black Africans. "NGAL was very specifically expressed in renal cysts—generating the new idea that NGAL may control the development of cysts in HIV-associated nephropathy," says Jonathan Barasch, MD, PhD (Columbia University, New York). He adds, "We and Prasad Devarajan, MD, identified NGAL in the kidney 10 years ago and its translation into a clinical entity in such a short time is quite a story. Almost every paper is positive for the association of NGAL and renal dysfunction/disease."

In the ICU study, patients with higher urine NGAL levels were more likely to develop acute kidney injury, even after adjustment for other factors. The rise in NGAL was present before any change in the standard test for AKI (serum creatinine level). Without other information, however, urine NGAL was no more effective in predicting AKI than clinical risk factors. Ikizler notes the study was limited by a lack of information on incidence of death or the need for dialysis, and by a lack of information on the patients' initial kidney function level.

In the HIV study, levels of urine NGAL were much higher in patients with HIV-associated nephropathy (HIVAN) than in patients with other forms of kidney disease, with or without HIV. HIVAN is an important complication of HIV, occurring mainly in patients of African descent.

Studies in mice suggested that NGAL may play an important role in the development of tubular disease and microcysts, which are specific features of HIVAN. Barasch notes that the human component of their study was limited by its small size but highlights the need for larger studies that definitively measure the NGAL monomer. He adds, "If our results are confirmed, measuring urine NGAL might help triage patients into different risk categories."

Other authors of the ICU study included Edward Siew, MD, and Lorranie B. Ware, MD (also of Vanderbilt University). The study was supported by NIH Grant UO1 HL081332 National Heart, Lung and Blood Institute, K24 DK62849 from the National Institute of Diabetes, Digestive and Kidney Diseases and Clinical Translational Science Award 1UL-1RR024975 from the National Center for Research Resources. E. Siew was partially supported by the National Kidney Foundation Research Fellowship Award and the Vanderbilt Mentored Clinical Research Scholar Program 5KL2 RR024977-02.

Other authors of the HIV study included Thomas Nickolas, MD, and Neal Paragas, MD (also of Columbia University); Christina Wyatt, MD, and Paul Klotman, MD (The Mount Sinai School of Medicine, New York); and Landino Allegri, MD (University of Parma, Italy). The co-authors report no disclosures. The study was supported by grants from the Emerald Foundation, the March of Dimes and the NIDDK (Grants DK-55388 and DK-58872) to J. Barasch. Columbia University and Cincinnati Children's have received licensing fees from Biosite and Abbott Diagnostics. The collection of patient specimens was supported by NIH grants R24MH59724 and U01MH083501 (The Manhattan HIV Brain Bank), P01DK56492, and by the Clinical Research Center of the Mount Sinai School of Medicine (M01-RR-00071).

The studies will appear online at http://jasn.asnjournals.org/ on July 23, 2009. Dr. Barasch's study is entitled, "Urinary NGAL Marks Cystic Disease in HIV-Associated Nephropathy," doi 10.1681/ASN.2009010065. Dr. Ikizler's study is entitled, "Urine Neutrophil Gelatinase-Associated Lipocalin Moderately Predicts Acute Kidney Injury in Critically Ill Adults," doi 10.1681/ASN.2008070673.

The American Society of Nephrology (ASN) does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, ASN is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

Shari Leventhal | EurekAlert!
Further information:
http://www.asn-online.org

More articles from Health and Medicine:

nachricht NTU scientists build new ultrasound device using 3-D printing technology
07.12.2016 | Nanyang Technological University

nachricht How to turn white fat brown
07.12.2016 | University of Pennsylvania School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

NTU scientists build new ultrasound device using 3-D printing technology

07.12.2016 | Health and Medicine

The balancing act: An enzyme that links endocytosis to membrane recycling

07.12.2016 | Life Sciences

How to turn white fat brown

07.12.2016 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>