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 Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

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: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Fighting drug resistant tuberculosis – InfectoGnostics meets MYCO-NET² partners in Peru

28.04.2017 | Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

 
Latest News

Wireless power can drive tiny electronic devices in the GI tract

28.04.2017 | Medical Engineering

Ice cave in Transylvania yields window into region's past

28.04.2017 | Earth Sciences

Nose2Brain – Better Therapy for Multiple Sclerosis

28.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>