Introduction: Acute kidney injury is associated with increased mortality in hospitalized cirrhotic patients;
therefore early and accurate diagnosis is crucial. The prognosis of AKI in cirrhosis depends on its specific
aetiology which remains a challenge.
Aim: We aimed to determine the accuracy of urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) for
diagnosis, differentiation of the various aetiologies of AKI in cirrhotics and to evaluate its value in short term
prognosis.
Methods: Eighty-two cirrhotic patients were investigated for uNGAL during hospital admission and AKI types
were determined blinded to uNGAL measurements. Patients were followed up till discharge.
Results: Patients with liver cirrhosis and renal impairment (n= 62) had significantly higher levels of uNGAL
(102.4 ±100 ng/ml) when compared with patients with cirrhotics with normal kidney function (n= 20) (102.4
±100 vs 17.4±14.71 ng/ml). Patients with acute tubular necrosis (ATN) had significantly higher uNGAL
(189.2±124 ng/ml) compared to other aetiologies, while prerenal azotemia had the lowest value (46.1±39.9
ng/ml). UNGAL levels were significantly higher in the mortality group of patients (p=0.006) and in patients
admitted to ICU (p<0.001) than the survivors and patient without ICU admission respectively. The AUC of
uNGAL for diagnosis of AKI was 0.892 with a cutoff > 33 ng/ml providing specificity 90% and sensitivity 79%.
In multivariate regression analysis, uNGAL was highly significant independent predictor of inpatient cirrhosis
relayed mortality.
Conclusion: UNGAL is a promising biomarker for diagnosis of AKI and differentiation between its different
aetiologies in cirrhosis including ATN, HRS and pre renal azotemia. UNGAL can independently predict poor
short term prognosis.
Research Department
Research Journal
Journal of Medical Science And clinical Research (JMSC)
Research Member
Research Publisher
IGM publication
Research Rank
1
Research Vol
Vol.05,Issue 02
Research Website
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.118
Research Year
2017
Research_Pages
PP.17926-17939
Research Abstract