Study of neutrophil gelatinase-associated lipocalin in patients with cardiovascular shock

Introduction: Acute kidney injury (AKI) makes a reversible accumulation of nitrogen products. This waste product is partly determined by serum creatinine level but it is not reliable during hypotension. However, neutrophil gelatinase-associated lipocalin (NGAL), as a new biomarker, shows an obvious increase even at hypotensive status. Objectives: The presented study was designed to evaluate NGAL as a right biomarker for AKI early diagnosis and consequent appropriate therapies. Patients and Methods: In this study, 25 healthy individuals and 47 cases out of 60 primarily admitted patients with low blood pressure were evaluated for NGAL level using blood samplings, health documents as well as analysis of questionnaires data. The group’s sizes were determined based on AKI and hypotension risk rates. Exclusion and inclusion criteria were firmly considered to avoid major confounding factors. Results: AKI was found in 20 cases out of 47 hypotensive patients. NGAL levels were about 243.35 ± 105.74 ng/dL (Mean ± SD) in AKI and 192.32 ± 64.31 ng/dL (Mean ± SD) in non-AKI hypotensive patients that showed a significant difference (P = 0.037) at the first 6 hours. There was no significant difference between hospitalization duration and NGAL level (P = 0.616). Conclusion: NGAL is important diagnostic protein in the early stages of AKI while there was no creatinine increasing. On the other hand, NGAL level during early 6 hours of hypotension introduces it as an indicative biomarker of AKI based on provided literature and our presented results.