Prediction and early diagnosis on cisplatin induced acute kidney injury through NGAL

OBJECTIVE:This study was to show that neutrophil gelatinase-associated lipocalin(NGAL) has an early predictive value of acute kidney injury(AKI) obtained by using cisplatin.METHODS:Serum creatinine(Scr),and NGAL levels of 60 chemotherapy patients were dynamically measured before and after cisplatin administration.Patients were divided into AKI group and non-AKI group by AKI diagnostic standard.The relationship of urinary NGAL level with AKI were studied.RESULTS:Scr peak value increased from 12 to 48 h,AKI was observed in 11 cases of 60 patients and the rate was 18.33%,NGAL increased peak within 2~8 h.In contrast with urinary NGAL levels before chemotherapy,the levels of AKI group increased at 2,4 and 8 h after chemotherapy,which was significant different(P0.01).The high levels would be kept at 8 and 12 h,but it was no significant difference(P0.05) compared with that before chemotherapy;compared with non-AKI group AKI group after 2,4,6 and 8 h urine NGAL levels were significantly higher,the difference was significant(P0.01).2-4 hours after chemotherapy urine NGAL levels was elevated and urinary NGAL levels in AKI group was still high 6 hours after chemotherapy,rather than the the AKI group falling to the normal reference range.Taking NGAL levels(x-±s) of non-AKI urine as the referent limitation for diagnosis of AKI,and according to the NGAL levels 6-8 hours after chemotherapy,the specificity for diagnosis was 100%(49/49),the sensitivity was 100% and diagnostic accuracy was 100%.For AKI group after chemotherapy,there is a linear correlation between Scr level at 24 h and urinary NGAL level at 2 h(r=0.864 4).CONCLUSIONS: Compared with the detection of serum creatinine,urine NGAL levels are more sensitive,more conductive to the occurrence of AKI after cisplatin chemotherapy.It can be used as an early diagnosis method for cisplatin-induced AKI.