- Poster presentation
- Open Access
Comparison of the value of plasma and urine cystatin-C and neutrophil gelatinase-associated lipocalin levels in prediction of acute kidney injury in sepsis
Critical Care volume 15, Article number: P15 (2011)
The aim was to study the impact of inflammation/sepsis on the concentrations of cystatin-C and neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine in adult ICU patients and to estimate the predictive properties of cystatin-C and NGAL in plasma and urine for early detection of acute kidney injury (AKI) in patients with sepsis.
The RIFLE class for AKI was calculated daily, while plasma and urinary Cys-C and NGAL were determined on days 0 and alternate days until ICU discharge. Test characteristics were calculated to assess the diagnostic performance of urinary and plasma Cys-C and NGAL. The diagnostic and predictive performances of the markers were assessed from the area under the receiver operator characteristic curve (AUC).
One hundred and twenty-eight patients were studied, and three groups were defined: normal (n = 41); sepsis (n = 45); and sepsis and AKI (n = 42). AUCs for diagnosis of AKI using plasma and uCys-C were as follows: 0.89 (P < 0.0001) and 0.91 (P < 0.0001) Cut-off points for AKI for plasma and uCys-C were 1.7 mg/l (sensitivity: 83%, specificity: 77%)and 0.11 mg/l (sensitivity = 92%, specificity = 80%), respectively. Urinary NGAL showed fair discrimination for AKI diagnosis (AUC = 0.85). Although plasma NGAL performed less well (AUC = 0.58).
Plasma and urinary Cys-C are useful markers in predicting AKI in sepsis. pNGAL is raised in patients with sepsis, and should be used with caution as a marker of AKI in ICU patients with sepsis. uNGAL is more useful in predicting AKI as the levels are not elevated in septic patients without AKI.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Gursel, G. Comparison of the value of plasma and urine cystatin-C and neutrophil gelatinase-associated lipocalin levels in prediction of acute kidney injury in sepsis. Crit Care 15 (Suppl 3), P15 (2011). https://doi.org/10.1186/cc10384
- Diagnostic Performance
- Acute Kidney Injury
- Characteristic Curve
- Septic Patient
- Predictive Performance