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Year : 2016  |  Volume : 26  |  Issue : 2  |  Page : 125-130

Neutrophil gelatinase-associated lipocalin as a biomarker of disease progression in patients with chronic kidney disease

1 Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
2 Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India
3 Department of Statistics, Indian Toxicology and Research Centre, Lucknow, Uttar Pradesh, India

Correspondence Address:
M L Patel
Department of Medicine, King George Medical University, C 28, Sec J, Aliganj, Lucknow - 226 024, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-4065.157799

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Chronic kidney disease (CKD) is associated with early mortality, decreased quality of life and increased health care expenditures. The aim of this study was to determine whether or not urinary NGAL (uNGAL) level is associated with renal damage and kidney disease progression in patients with CKD and to evaluate the predictive value of uNGAL in progression of CKD. Totally, 91 cases of CKD stage II, III, IV, and 50 age-matched healthy controls were enrolled. The follow-up end-point was 18 months; end-point of the study was progression to an estimated glomerular filtration rate (eGFR) of <15 ml/min and/or CKD stage V. Forty-five cases (49.4%) were progressors and 46 were nonprogressors. uNGAL levels were significantly higher in CKD subjects as compared to healthy controls (log 1.09 ± 0.22 μg/ml in controls versus log 1.22 ± 2.08 μg/ml in stage II, log 3.34 ± 2.74 μg/ml in stage III and log 3.70 ± 0.18 μg/ml in stage IV). Univariate Cox proportional hazards model showed that only eGFR (hazard ratio [HR]: 0.95; 95% confidence interval [CI]: 0.93-0.96; P < 0.001) and uNGAL (HR: 1.11; 95% CI: 1.01-1.20; P < 0.001) were significantly associated with end-point of CKD stage V, but multiple Cox proportional regression model showed significant association of uNGAL (HR: 1.11; 95% CI: 1.01-1.20; P < 0.001) and eGFR (HR: 0.962, 95% CI: 0.95-0.98; P < 0.001) with end-point of CKD stage V. This suggests that uNGAL would not be a simple surrogate index of baseline eGFR, but a marker of CKD progression beyond the information provided by eGFR estimation.


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Indian Journal of Nephrology
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Online since 20th Sept '07