Biomarkers of Acute Renal Failure

Studies Support NGAL as a Biomarker of AKI in the Following Situations

August 2009

Over the last several years, many clinical studies have been completed looking at urinary NGAL as a biomarker of acute kidney injury. It appears to be a very rapid and useful predictor of acute kidney injury amongst pediatric patients having cardiac surgery or at risk for contrast-induced kidney damage. A recent study in adults also found that increased urinary NGAL release was a good predictor of subsequent kidney injury in patients admitted from a large emergency room. Unfortunately, NGAL also increases somewhat in the urine of patients with chronic kidney disease. Therefore, it may be that NGAL is a better marker of acute injury in pediatric patients as opposed to adult patients, since chronic kidney disease is more commonly a disease of adults. Already mentioned, NGAL is very stable in urine, which does make it a very convenient analyte for the laboratory.

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Studies Support NGAL as a Biomarker of AKI

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• Introduction
• Acute Kidney Injury
• Common Causes of Acute
• Progression From Pre-renal to Acute Tubular Necrosis
• Towards a Kidney Troponin
• Origin of Formed Elements in Urinalysis
• Urinanalysis: A Traditional Biomarker of AKI
• Hyaline Casts
• Renal Epithelial Cell Cast
• Leukocyte Cast
• RBC Cast
• Pigmented Cast
• Granular Cast
• Other Helpful Indices
• Potential Sources of Urinary Biomarkers
• NGAL as a Biomarker
• Studies Support NGAL as a Biomarker of AKI in the Following Situations
• Mayo Renal Laboratory Urinary NGAL Normals
• Normal Urinary NGAL Levels are Not Dependent on Age, but are Higher in Women than Men
• Ongoing Mayo Clinic Clinical Validation Study
• Ongoing Mayo Clinic Clinical Validation Study: Preliminary Results
• Study
• Other Potential Markers on the Horizon
• Mayo Clinic Goals
• Conclusions
• References
• Questions?