Neutrophil gelatinase associated lipocalin (NGAL) and the evolution of the acute kidney injury in intensive care patients

Abstract

The incidence of AKI varies from 5% in hospitalized patients to 30% of patients in intensive care units. Over the last 50 years, mortality rates remained unchanged for adults patients at 50-70%. An important issue concerning the diagnosis of AKI is that the clinical standard, the serum creatinine, is a suboptimal method to evaluate AKI and it that doesn´t present the ability to launch potentially effective therapies in a timely manner and it is not able to indicate patients evolution. The residual renal function identification and the prevision of the irrerversible dysfunction are strategies that could be applied in the clinical evaluation of these patients. NGAL, a protein that is induced in kidney tubule cells and easily detected in the plasma and urine, represents an early predictive biomarker of AKI, much before the rise in serum creatinine. It is highly correlated with the degree of the injury and it predicts AKI severity, indicates the injury progression and regression, and forecast the need for RRT. The objective of this study is to characterize the evolution of the renal function of patients with AKI by using NGAL and serum creatinine. Nurses are deeply involved with the resolution of the epidemiologic aspects of this acute injury. (AU)