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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Serum neutrophil gelatinase-associated lipocalin at inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury. | Kumpers et al. Critical Care 2010 14 R9 http ccforum.eom content 14 1 R9 c CRITICAL CARE RESEARCH Open Access Serum neutrophil gelatinase-associated lipocalin at inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury Philipp Kumpers1 2 3 Carsten Hafer13 Alexander Lukasz1 Ralf Lichtinghagen3 Korbinian Brand3 Danilo Fliser4 Robert Faulhaber-Walter13 Jan T Kielstein13 Abstract Introduction Neutrophil gelatinase-associated lipocalin NGAL is a promising novel biomarker that correlates with the severity and outcome of acute kidney injury AKI . However its prognostic utility during the late course of AKI especially in patients that require renal replacement therapy RRT remains unknown. The aim of this study was to evaluate the predictive value of serum NGAL in patients with established AKI at inception of RRT in the intensive care unit ICU . Methods Serum NGAL ELISA methodology was measured in 109 critically ill patients with AKI at inception of RRT in 7 ICUs of a tertiary care university hospital. The primary outcome studied was 28-day mortality. Secondary outcome measures were ICU length of stay ventilator-free days and renal recovery at day 28. Results There was a significant difference in serum NGAL between healthy subjects median interquartile range 39.0 37.5-42.75 ng mL critically ill patients with systemic inflammatory response syndrome SIRS 297 184-490 ng mL and critically ill patients with sepsis 708 365-1301 ng mL P 0.0001 respectively. Multiple linear regression showed that NGAL levels were independently related to the severity of AKI and the extent of systemic inflammation. NGAL levels were higher in non-survivors 430 303-942 ng mL compared to survivors 298 159506 ng mL P 0.004 . Consistently Cox proportional hazards regression analysis identified NGAL as a strong independent predictor for 28-day survival hazard ratio 1.6 95 confidence interval CI 1.15 - 2.23 P 0.005 . Conclusions This is the first .
