Neutrophil gelatinase-associated lipocalin for early diagnosis of acute kidney injury in patients with acute decompensated heart failure

Background: the incidence of acute kidney injury (AKI) is high in patients with acute decompensated heart failure (ADHF) and is linked with increased morbidity and mortality rates. Predictive biomarkers of AKI could allow improve outcomes in AKI. Purpose: to evaluate the value of serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations for early diagnosis of AKI in patients with ADHF with left ventricular (LV) systolic function. Methods: we enrolled 60 men (average age was 62.0±11.1 years) hospitalized with ADHF with reduced LV systolic function (LV ejection fraction (LVEF) <40%). AKI was defined according to KDIGO Clinical Practice Guidelines. We measured of serum NGAL (sNGAL) concentrations by a quantitative sandwich enzyme immunoassay technique (RD systems, DLCN20, USA) at admission. Results: sNGAL concentrations were significantly higher in patients with AKI 171.2 (159.0-241.2) ng/mL compared without AKI 136.8 (108.2-163.0) ng/mL P < 0.001. For predicting AKI, ROC analysis was performed. Ерe area under curve (AUC) of sNGAL concentrations at admission was 0.83 (95% confidence interval [95% CI], 0.73 to 0.93; P<0.001). A cutoff of 157.35 ng/mL yielded sensitivity (0.83) and specificity (0.74). sNGAL concentrations > 157.35 ng/mL had 13.8-fold increase in the odds of developing AKI (95% CI, 3.93 to 48.42). Conclusion: sNGAL can be used for early diagnosis of AKI in patients with ADHF with reduced LV systolic function.

ЛИПОКАЛИН, АССОЦИИРОВАННЫЙ С ЖЕЛАТИНАЗОЙ НЕЙТРОФИЛОВ, ОСТРАЯ ДЕКОМПЕНСАЦИЯ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ, ОСТРОЕ ПОВРЕЖДЕНИЕ ПОЧЕК, КРЕАТИНИН, СКОРОСТЬ КЛУБОЧКОВОЙ ФИЛЬТРАЦИИ, neutrophil gelatinase-associated lipocalin, acute decompensation of chronic heart failure, acute kidney injury, creatinine, glomerular filtration rate

1. Kashani K., Cheungpasitporn W., Ronco C. Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption. Clinical Chemistry and Laboratory Medicine (CCLM). 2017,55 (8):1074-89. DOI:10.1515/cclm-2016-0973

2. Моисеев В. С., Мухин Н. А., Смирнов А. В., Кобалава Ж. Д., Бобкова И. Н., Виллевальде С. В. и др. Сердечно-сосудистый риск и хроническая болезнь почек: стратегии кардио-нефропротекции. Российский кардиологический журнал. 2014,8:7-37. DOI:10.15829/1560-4071-2014 -8-7-37

3. Кобалава Ж. Д., Виллевальде С. В., Моисеев В. С. Сердечно-сосудистые заболевания и функциональное состояние почек. Российский Кардиологический Журнал. 2013,18 (4):33-7. DOI :10.15829/1560-4071-2013-4-33-37

4. Kellum, JA, Lameire, N., Aspelin, P., Barsoum, RS, Burdmann, EA, Goldstein, SL et al. Kidney disease: Improving global outcomes (KDI-GO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney International Supplements. 2012,2 ( 1 ): 1-138. DOI:10.1038/kisup. 2012.1

5. Shyam R., Patel M., Sachan R., Kumar S., Pushkar D. Role of urinary neutrophil gelatinase-associated lipocalin as a biomarker of acute kidney injury in patients with circulatory shock. Indian Journal of Critical Care Medicine. 2017,21 (11):740-5. DOI:10.4103/ijccm. IJC-CM_315_17

6. Терещенко С. Н., Жиров И. В., Насонова С. Н., Николаева О. А., Ледяхова М. В. Патофизиология острой С.Н. Что нового? Российский Кардиологический Журнал. 2016, (9 (137)): 52-64.

7. Ahn JY, Lee MJ, Seo JS, Choi D., Park J.B. Plasma neutrophil gelatinase-associated lipocalin as a predictive biomarker for the detection of acute kidney injury in adult poisoning. Clinical Toxicology. 2016,54 (2):127-33. DOI:10.3109/15563650.2015.1118487

8. Khatami M., Sabbagh MRP, Nikravan N., Khazaeipour Z., Boroumand M., Sadeghian S. et al. The role of neutrophil-gelatinase-associated lipocalin in early diagnosis of contrast nephropathy. Indian Journal of Nephrology. 2015,25 (5):292. DOI:10.4103/0971-4065.147370

9. Вельков В. В. Цистатин С. и NGAL - маркеры преклинической ренальной дисфункции и субклинического острого повреж дения почек. Лабораторная Служба. 2015,4 (2):38-43.

10. Nasioudis D., Witkin S.S. Neutrophil gelatinase-associated lipocalin and innate immune responses to bacterial infections. Medical Microbiology and Immunology. 2015,204 (4):471-9. DOI:10.1007/s00430-015-0394-1

11. Roudkenar MH, Halabian R., Bahmani P., Roushandeh AM, Kuwahara Y., Fukumoto M. Neutrophil gelatinase-associated lipocalin: A new antioxidant that exerts its cytoprotective effect independent on Heme Oxygenase-1. Free Radical Research. 2011,45 (7):810-9. DOI:10.31 09/10715762.2011.581279

12. Patsaoura A., Tatsi E., Margeli A., Kanavaki I., Delaporta P., Kyriakopoulou D. et al. Plasma neutrophil gelatinase-associated lipocalin levels are markedly increased in patients with non-transfusion-dependent thalassemia: Lack of association with markers of erythropoiesis, iron metabolism and renal function. Clinical Biochemistry. 2014,47 (12):1060-4. DOI:10.1016/j. clinbiochem. 2014.03.017

13. Eilenberg W., Stojkovic S., Kaider A., Kozakowski N., Domenig CM, Burghuber C. et al. NGAL and MMP-9/NGAL as biomarkers of plaque vulnerability and targets of statins in patients with carotid atherosclerosis. Clinical Chemistry and Laboratory Medicine (CCLM). 2017,56 (1):147-56. DOI:10.1515/cclm-2017-0156

14. Cabedo Martinez A-I, Weinhäupl K., Lee W-K, Wolff NA, Storch B., Zerko S. et al. Biochemical and Structural Characterization of the Interaction between the Siderocalin NGAL/LCN2 (Neutrophil Gelatinase-associated Lipocalin/Lipocalin 2) and the N-terminal Domain of Its Endocytic Receptor SLC22A17. Journal of Biological Chemistry. 2016,291 (6):2917-30. DOI:10.1074/jbc. M115.685644

15. Beker BM, Corleto MG, Fieiras C., Musso C.G. Novel acute kidney injury biomarkers: their characteristics, utility and concerns. International Urology and Nephrology. 2018,50 (4):705-13. DOI:10.1007/s11255-017-1781-x

16. Kokkoris S., Pipili C., Grapsa E., Kyprianou T., Nanas S. Novel Biomarkers ofAcute Kidney Injury in the General Adult ICU: A Review. Renal Failure. 2013,35 (4):579-91. DOI:10.3109/0886022X. 2013.773835

17. Singer E., Marko L., Paragas N., Barasch J., Dragun D., Müller DN et al. Neutrophil gelatinase-associated lipocalin: pathophysiology and clinical applications. Acta Physiologica. 2013,207 (4):663-72. DOI:10.1111/apha. 12054

18. Hang C-C, yang J., Wang S., Li C-S, Tang Z-R. Evaluation of serum neutrophil gelatinase-associated lipocalin in predicting acute kidney injury in critically ill patients. Journal of International Medical Research. 2017,45 ( 3):1231-44. DOI:10.1177/0300060517709199

19. Alvelos M., Lourenço P., Dias C., Amorim M., Rema J., Leite AB et al. Prognostic value of neutrophil gelatinase-associated lipocalin in acute heart failure. InternationalJournal of Cardiology. 2013,165 (1):51-5. DOI:10.1016/j. ijcard. 2011.07.080

20. Alge JL, Arthur J.M. Biomarkers of AKI: A Review of Mechanistic Relevance and Potential Therapeutic Implications. Clinical Journal of the American Society of Nephrology. 2015,10 (1):147-55. DOI: 10.2215/CJN. 12191213

21. Wasung ME, Chawla LS, Madero M. Biomarkers of renal function, which and when? Clinica Chimica Acta. 2015,438:350-7. DOI:10.1016/j. cca. 2014.08.039

22. de Geus HRH, Bakker J., Lesaffre EMEH, le Noble JLML. Neutrophil Gelatinase-associated Lipocalin at ICU Admission Predicts for Acute Kidney Injury in Adult Patients. American Journal of Respiratory and Critical Care Medicine. 2011,183 (7):907-14. DOI:10.1164/rccm. 200908-1214OC

23. Van Veldhuisen DJ, Ruilope LM, Maisel AS, Damman K. Biomarkers of renal injury and function: diagnostic, prognostic and therapeutic implications in heart failure. European Heart Journal. 2016,37 (33):2577-85. DOI:10.1093/eurheartj/ehv588

24. Aghel A., Shrestha K., Mullens W., Borowski A., Tang WHW. Serum Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Predicting Worsening Renal Function in Acute Decompensated Heart Failure. Journal of Cardiac Failure. 2010,16 (1):49-54. DOI:10.1016/j. card-fail. 2009.07.003

25. Breidthardt T., Socrates T., Drexler B., Noveanu M., Heinisch C., Aren-ja N. et al. Plasma neutrophil gelatinase-associated lipocalin for the prediction of acute kidney injury in acute heart failure. Critical Care. 2012.16 (1):R2.DOI:10.1186/cc10600

26. Mortara A., Bonadies M., Mazzetti S., Fracchioni I., Delfino P., Chiof-fi M. et al. Neutrophil gelatinase-associated lipocalin predicts worsening of renal function in acute heart failure: methodological and clinical issues. Journal of Cardiovascular Medicine. 2013,14 (9):629-34. DOI:10.2459/JCM. 0b013e3283629ca6

27. Palazzuoli A., Ruocco G., Beltrami M., Franci B., Pellegrini M., Lucani B. et al. Admission plasma neutrophil gelatinase associated lipocalin (NGAL) predicts worsening renal function during hospitalization and post discharge outcome in patients with acute heart failure. Acute Cardiac Care. 2014.16 (3):93-101. DOI:10.3109/17482941.2014.911915

28. Alvelos M., Pimentel R., Pinho E., Gomes A., Lourenco P., Teles MJ et al. Neutrophil Gelatinase-Associated Lipocalin in the Diagnosis of Type 1 Cardio-Renal Syndrome in the General Ward. Clinical Journal of the American Society of Nephrology. 2011,6 (3):476-81. DOI: 10.2215/CJN. 06140710

29. Shrestha K., Shao Z., Singh D., Dupont M., Tang WHW. Relation of Systemic and Urinary Neutrophil Gelatinase-Associated Lipocalin Levels to Different Aspects of Impaired Renal Function in Patients With Acute Decompensated Heart Failure. "Шє American Journal of Cardiology. 2012,110 (9):1329-35. DOI:10.1016/j. amjcard. 2012.06.035

30. Macdonald S., Arendts G., Nagree Y., Xu X-F. Neutrophil Gelatinase-Associated Lipocalin (NGAL) predicts renal injury in acute decompensated cardiac failure: a prospective observational study. BMC Cardiovascular Disorders [Интернет]. 2012 [цитируется по 2 марта 2018 г.],12 (1). DOI:10.1186/1471-2261-12-8

31. Angeletti S., Fogolari M., Morolla D., Capone F., Costantino S., Spoto S. et al. Role of Neutrophil Gelatinase-Associated Lipocalin in the Diagnosis and Early Treatment of Acute Kidney Injury in a Case Series of Patients with Acute Decompensated Heart Failure: A Case Series. Cardiology Research and Practice. 2016,2016:1-9. DOI: 10.1155/2016/3708210

32. Терещенко С. Н., Жиров И. В., Нарусов О. Ю., Мареев Ю. В., Затейщиков Д. А., Осмоловская Ю. Ф. и др. Диагностика и лечение хронической и острой С.Н. Кардиологический вестник. 2016,11 (2):3-33.

33. Бойцов С. А., Готье С. В., Жиров И. В., Колачев И. И., Костенко В. А., Кочетов А. Г. и др. Рекомендации по ведению пациентов с острой СН на догоспитальном и госпитальном этапах оказания медицинской помощи. (часть 1). Неотложная Кардиология. 2016,4:33-61.

34. Бойцов С. А., Готье С. В., Жиров И. В., Колачев И. И., Костенко В. А., Кочетов А. Г. и др. Рекомендации по ведению пациентов с острой СН на догоспитальном и госпитальном этапах оказания медицинской помощи (часть 2). Неотложная Кардиология. 2017,1 (4-1):34-59.

35. Бойцов С. А., Готье С. В., Жиров И. В., Колачев И. И., Костенко В. А., Кочетов А. Г. и др. Рекомендации по ведению пациентов с острой СН на догоспитальном и госпитальном этапах оказания медицинской помощи (часть 3). Неотложная кардиология. 2017,14 (2):43-64.

36. Ponikowski P., Voors AA, Anker SD, Bueno H., Cleland JGF, Coats AJS et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Journal of Heart Failure. 2016,18 (8):891-975. DOI:10.1002/ejhf. 592

37. Palazzuoli A., Ruocco G., Pellegrini M., De Gori C., Del Castillo G., Franci B. et al. Comparison of Neutrophil Gelatinase-Associated Lipocalin Versus B-Type Natriuretic Peptide and Cystatin C. to Predict Early Acute Kidney Injury and Outcome in Patients With Acute Heart Failure. The American Journal of Cardiology. 2015,116(1):104-11. DOI:10.1016/j. amjcard.2015.03.043