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Asian Journal of Biochemistry
  Year: 2018 | Volume: 13 | Issue: 1 | Page No.: 15-21
DOI: 10.3923/ajb.2018.15.21
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Neutrophil Gelatinase Associated Lipocalin (NGAL), an Early Marker for Urinary Tract Infection and Acute Kidney Injury
U. Munilakshmi , K.N. Shashidhar , C. Muninarayana, Madhavi Reddy and V. Lakshmaiah

Background and Objective: Acute kidney injury (AKI) is associated with high morbidity and mortality. Urinary tract infection (UTI) may be associated with sepsis or septic shock, also a major risk factor for diabetics and cause sudden deterioration of renal function. The present study was aimed to examine the microbiological spectrum of UTI and to investigate either serum NGAL could be a promising diagnostic biomarker of AKI following UTI in comparison to other parameters related to renal scaring. Materials and Methods: Subjects enrolled in the study comprised 300 with and without diabetes mellitus. Variables such as blood glucose, serum and urine creatinine, urea, hs-CRP and urine Albumin were analyzed by enzymatic methods in Vitros 5.1 FS, HbA1c by HPLC (Bio Rad D10, USA), Serum Neutrophil Gelatinase Associated Lipocalin (NGAL) and Cystatin C by enzyme linked immunosorbent assay kit (Biovendor, USA). Diagnosis of UTI was made from Midstream urine samples of patients with urine culture of > 105 colony forming units (CFUs) mL–1 of a pathogen. Comparison of one time data between three study groups and within Group III was done by One way Analysis of Variance (ANOVA). Correlation among continuous data was performed by the Pearsons correlation coefficients. Area under curve (AUC) was calculated by plotting Receiver operating characteristic curve (ROC). Statistical software program (licensed version 20.0, SPSS, Chicago, IL) was used for all analysis. Results: Mean values of biochemical variables such as NGAL, Cystatin C, SCr, hs-CRP and albumin creatinine ratio (ACR) were significant in Group III compared to Groups I and II. Mean±SD of these biochemical variables within Group III associated with UTI was also observed from ‘0’ day to 14th day. With Pearson’s correlation analysis, Scr was significant and positively correlated with NGAL, eGFR, Cystatin C, Urea and hs-CRP. However, NGAL showed strong positive correlation and statistically significant with Scr, eGFR, Urea, hs-CRP, ACR and Cys C. Pair wise comparison of ROC analysis at 95% confidence Interval serum NGAL with an AUC of (0.977, p = 0.001), Cystatin C (0.580, p = 0.41), SCr (0.756, p = 0.04) and ACR (0.654, p = 0.04) was observed. Conclusion: Physicians should pay attention to UTI patients at risk of AKI (advancing age, DM, upper UTI, afebrile and impaired baseline renal function). Biochemical investigations such as NGAL and hs-CRP play an important role as an adjuvant and surrogate markers in early diagnosis of UTI in parallel to microbiological investigations.
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How to cite this article:

U. Munilakshmi, K.N. Shashidhar, C. Muninarayana, Madhavi Reddy and V. Lakshmaiah, 2018. Neutrophil Gelatinase Associated Lipocalin (NGAL), an Early Marker for Urinary Tract Infection and Acute Kidney Injury. Asian Journal of Biochemistry, 13: 15-21.

DOI: 10.3923/ajb.2018.15.21








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