ABSTRACT

Introduction: Human lipocalin-2, known as neutrophil gelatinase–associated lipocalin (NGAL), is a widely studied biomarker of acute kidney injury (AKI).

Areas covered: NGAL can serve as a predictor of AKI, disease progression, and mortality and can help in differentiating between AKI etiologies. We conducted a systematic review in the PubMed and Medline databases involving the clinical application of NGAL in patients with AKI.

Expert opinion: In this review, we explored the usefulness of NGAL for AKI or clinical outcome prediction. The use of urine or blood NGAL levels alone or in combination with a clinical prediction model may facilitate AKI prediction, severity prediction, AKI etiological differentiation, and mortality prediction. For AKI prediction, urine and plasma NGAL levels have an area under the curve (AUC) ranging from 0.71 to 0.90 and from 0.71 to 0.89, respectively, in different populations. The diagnostic performance of NGAL alone for renal replacement therapy or successful discontinuation prediction is suboptimal (AUC range: 0.65–0.81). Sepsis limits the application of NGAL as a clinical predictor, and the prediction performance of NGAL is affected by baseline renal function, timing of sample collection, and underlying comorbidities. The lack of internationally approved reference material also limits the usefulness of NGAL.

摘要

简介：人类脂质运载蛋白 2，称为中性粒细胞明胶酶相关脂质运载蛋白 (NGAL)，是一种广泛研究的急性肾损伤 (AKI) 生物标志物。

涵盖的领域：NGAL 可作为 AKI、疾病进展和死亡率的预测指标，并有助于区分 AKI 病因。我们在 PubMed 和 Medline 数据库中进行了系统评价，涉及 NGAL 在 AKI 患者中的临床应用。

专家意见：在这篇综述中，我们探讨了 NGAL 对 AKI 或临床结果预测的有用性。单独使用尿液或血液 NGAL 水平或与临床预测模型结合使用可促进 AKI 预测、严重程度预测、AKI 病因分化和死亡率预测。对于 AKI 预测，尿液和血浆 NGAL 水平在不同人群中的曲线下面积 (AUC) 分别为 0.71 至 0.90 和 0.71 至 0.89。单独使用 NGAL 对肾脏替代治疗或成功停药预测的诊断性能欠佳（AUC 范围：0.65-0.81）。脓毒症限制了 NGAL 作为临床预测指标的应用，NGAL 的预测性能受基线肾功能、样本采集时间和潜在合并症的影响。