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Plasma neutrophil gelatinase-associated lipocalin (NGAL) is an indicator of interstitial damage and a predictor of kidney function worsening of chronic kidney disease in the early stage: a pilot study

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Abstract

Background

The aim of this study was to examine whether plasma neutrophil gelatinase-associated lipocalin (NGAL) levels predict the outcome of kidney function and correlate with the severity of tubulointerstitial damages in patients with chronic kidney disease (CKD).

Methods

In this prospective 18-month cohort study of 112 patients with CKD between 2010 and 2011, associations between plasma NGAL levels and estimated glomerular filtration ratio (eGFR), further worsening of kidney function and histological lesion on kidney biopsy were investigated.

Results

Serum levels of creatinine and eGFR before the study were 1.48 ± 0.65 mg/dl and 42.6 ± 22.0 ml/min/1.73 m2. Median plasma NGAL level was 148.5 (83.75–248.25) ng/ml and showed no correlation with eGFR or age. 87 out of 112 patients were able to follow up for 18 months. Patients with higher levels of NGAL (>107.8 ng/ml) showed significantly more decrease in eGFR in CKD stage 1 or 2 than those with lower levels of NGAL (≦107.8 ng/ml), while there was no difference in change in eGFR in CKD stage 3–5 between patients with higher and lower levels of NGAL. In the kidney biopsy of 27 patients out of enrolled patients, plasma NGAL levels correlated significantly with the degree of interstitial cell infiltration and fibrosis, but did not correlate with that of glomerular sclerosis. In ROC analysis, plasma NGAL levels predicted tubulointerstitial cell infiltrations more accurately [AUC = 0.8300 than eGFR (AUC = 0.716)].

Conclusion

Plasma NGAL is a useful marker of interstitial lesions in patients with CKD and a predictor of further kidney worsening in the early CKD stage.

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Authors and Affiliations

  1. Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, 247-8533, Japan

    Hidekazu Moriya, Yasuhiro Mochida, Kunihiko Ishioka, Machiko Oka, Kyoko Maesato, Sumi Hidaka, Takayasu Ohtake & Shuzo Kobayashi

  2. Department of Center of Clinical and Translational Science, Shonan Kamakura General Hospital, Kanagawa, Japan

    Hidekazu Moriya, Yasuhiro Mochida, Kunihiko Ishioka, Machiko Oka, Kyoko Maesato, Sumi Hidaka, Takayasu Ohtake & Shuzo Kobayashi

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  1. Hidekazu Moriya
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  2. Yasuhiro Mochida
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  3. Kunihiko Ishioka
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  4. Machiko Oka
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  5. Kyoko Maesato
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  6. Sumi Hidaka
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  7. Takayasu Ohtake
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  8. Shuzo Kobayashi
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Correspondence to Hidekazu Moriya.

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Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB Approval No. TGE00115-024) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Moriya, H., Mochida, Y., Ishioka, K. et al. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is an indicator of interstitial damage and a predictor of kidney function worsening of chronic kidney disease in the early stage: a pilot study. Clin Exp Nephrol 21, 1053–1059 (2017). https://doi.org/10.1007/s10157-017-1402-0

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  • DOI: https://doi.org/10.1007/s10157-017-1402-0

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