Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Derek S. Wheeler, Prasad Devarajan, Qing Ma, Kelli Harmon, Marie Monaco, Natalie Cvijanovich, Hector R. Wong

Research output: Contribution to journalArticlepeer-review

256 Scopus citations

Abstract

OBJECTIVE: To validate serum neutrophil gelatinase-associated lipocalin (NGAL) as an early biomarker for acute kidney injury in critically ill children with septic shock. DESIGN: Observational cohort study. SETTING: Fifteen North American pediatric intensive care units (PICUs). PATIENTS: A total of 143 critically ill children with systemic inflammatory response syndrome (SIRS) or septic shock and 25 healthy controls. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Serum NGAL was measured during the first 24 hrs of admission to the PICU. Acute kidney injury was defined as a blood urea nitrogen concentration >100 mg/dL, serum creatinine >2 mg/dL in the absence of preexisting renal disease, or the need for dialysis. There was a significant difference in serum NGAL between healthy children (median 80 ng/mL, interquartile ratio [IQR] 55.5-85.5 ng/mL), critically ill children with SIRS (median 107.5 ng/mL, IQR 89-178.5 ng/mL), and critically ill children with septic shock (median 302 ng/mL, IQR 151-570 ng/mL; p < .001). Acute kidney injury developed in 22 of 143 (15.4%) critically ill children. Serum NGAL was significantly increased in critically ill children with acute kidney injury (median 355 ng/mL, IQR 166-1322 ng/mL) compared with those without acute kidney injury (median 186 ng/mL, IQR 98-365 ng/mL; p = .009). CONCLUSIONS: Serum NGAL is a highly sensitive but nonspecific predictor of acute kidney injury in critically ill children with septic shock. Further validation of serum NGAL as a biomarker of acute kidney injury in this population is warranted.

Original languageEnglish (US)
Pages (from-to)1297-1303
Number of pages7
JournalCritical care medicine
Volume36
Issue number4
DOIs
StatePublished - Apr 2008

Keywords

  • Acute kidney injury
  • Biomarker
  • Septic shock
  • Serum neutrophil gelatinase-associated lipocalin

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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