Article ; Online: Performance of urinary kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, and N-acetyl-β-D-glucosaminidase to predict chronic kidney disease progression and adverse outcomes.
2017 Volume 50, Issue 5, Page(s) e6106
Abstract: Urinary biomarkers can predict the progression of chronic kidney disease (CKD). In this study, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and N-acetyl-β-D-glucosaminidase (NAG) were correlated with the stages of ... ...
| Abstract | Urinary biomarkers can predict the progression of chronic kidney disease (CKD). In this study, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and N-acetyl-β-D-glucosaminidase (NAG) were correlated with the stages of CKD, and the association of these biomarkers with CKD progression and adverse outcomes was determined. A total of 250 patients, including 111 on hemodialysis, were studied. Urinary KIM-1, NGAL, and NAG were measured at baseline. Patients not on dialysis at baseline who progressed to a worse CKD stage were compared with those who did not progress. The association of each biomarker and selected covariates with progression to more advanced stages of CKD, end-stage kidney disease, or death was evaluated by Poisson regression. NGAL was moderately correlated (rs=0.467, P<0.001) with the five stages of CKD; KIM-1 and NAG were also correlated, but weakly. Sixty-four patients (46%) progressed to a more advanced stage of CKD. Compared to non-progressors, those patients exhibited a trend to higher levels of KIM-1 (P=0.064) and NGAL (P=0.065). In patients not on dialysis at baseline, NGAL was independently associated with progression of CKD, ESKD, or death (RR=1.022 for 300 ng/mL intervals; CI=1.007-1.037, P=0.004). In patients on dialysis, for each 300-ng/mL increase in urinary NGAL, there was a 1.3% increase in the risk of death (P=0.039). In conclusion, urinary NGAL was associated with adverse renal outcomes and increased risk of death in this cohort. If baseline urinary KIM-1 and NGAL predict progression to worse stages of CKD is something yet to be explored. |
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| MeSH term(s) | Acetylglucosaminidase/urine ; Adult ; Age Factors ; Aged ; Analysis of Variance ; Biomarkers/urine ; Creatinine/blood ; Creatinine/urine ; Disease Progression ; Female ; Glomerular Filtration Rate ; Hepatitis A Virus Cellular Receptor 1/analysis ; Humans ; Lipocalin-2/urine ; Male ; Middle Aged ; Predictive Value of Tests ; Reference Standards ; Reference Values ; Renal Dialysis ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/pathology ; Renal Insufficiency, Chronic/physiopathology ; Renal Insufficiency, Chronic/urine ; Reproducibility of Results ; Risk Factors ; Sex Factors ; Statistics, Nonparametric |
| Chemical Substances | Biomarkers ; HAVCR1 protein, human ; Hepatitis A Virus Cellular Receptor 1 ; LCN2 protein, human ; Lipocalin-2 ; Creatinine (AYI8EX34EU) ; Acetylglucosaminidase (EC 3.2.1.52) |
| Language | English |
| Publishing date | 2017-03-30 |
| Publishing country | Brazil |
| Document type | Evaluation Studies ; Journal Article |
| ZDB-ID | 786234-9 |
| ISSN | 1414-431X ; 0100-879X |
| ISSN (online) | 1414-431X |
| ISSN | 0100-879X |
| DOI | 10.1590/1414-431X20176106 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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