The Value of Serum NGAL in Determination of Dialysis Indication

Abstract

Objective: To investigate if Neutrophil Gelatinase-associated Lipocalin can be used or not as a biochemical marker to determine the indications for emergency dialysis treatment.

Methods: The study was conducted at the Emergency Department of Numune Taraining and Research Hospital, Ankara, Turkey, in 2012, and comprised 60 patients who had uraemic symptoms and abnormal laboratory tests, including elevated potassium, blood urea nitrogen, and creatinine level or lowered pH and bicarbonate. They were divided in to 2 equal groups as those having indication for dialysis (Group 1) and those not having such indications (Group 2). Relevant values, including that of Neutrophil Gelatinase-associated Lipocalin, were compared between the two groups. To assess the utility of Neutrophil Gelatinase-associated Lipocalin measurements at varying cut-off values to predict indications for dialysis, a conventional receiver operating characteristic curve was generated and the area under the curve was calculated. P<0.05 was considered statistically significant.

Results: The mean age of the 30 patients in Group 1 was 68.29 +/- 16.9 years, while in Group 2 it was 66.47 +/- 14.2 years (p<0.65). The mean Neutrophil Gelatinase-associated Lipocalin level was 817.65 +/- 334.76ng/mL in Group 1 and 398.97 +/- 202.42ng/mL in Group 2 (p<0.001). The best cut-off level for Neutrophil Gelatinase-associated Lipocalin to predict emergency haemodialysis indication was 615ng/mL with a sensitivity of 82% and a specificity of 80%, and the areas under curve was 0.84.

Conclusion: Serum Neutrophil Gelatinase-associated Lipocalin level may be a determining parameter for indication of emergency haemodialysis.