Objective: Early recognition of sepsis is important to preventprogression to severe sepsis and septic shock conditions thatmay lead to Acute Kidney Injury (AKI). In the present study, thecombined measurement of plasma biomarkers NGAL, PCT andMR-proADM in the diagnosis and prognosis of sepsis andsepsis associated acute kidney injury (SA-AKI) was evaluated.Methods: Twenty patients with sepsis, 18 with localizedinfections, 17 with SIRS and 24 healthy donors have beenconsecutively enrolled: NGAL, PCT and MR-proADM weremeasured at admission (T=0), at 24 hours (T=1) and in thethird or fifth day of antibiotic therapy (T=3-5) in septic patientsand as a single determination (T=0) in the remaining subjects.PCT and MR-proADM were measured by a time-resolvedamplified emission method (Kryptor; Brahms AG, Hennigsdorf,Germany). NGAL was measured by turbidimetric immunoassay(NGAL Test, Bio Porto Diagnostics, Denmark). The creatininewas determined using an enzymatic IDM tracedspectrophotometric method (Siemens, Healthcare DiagnosticsInc., Italy). Data were analyzed using the statistical packageMedCalc 13.2.2.0.Results: NGAL values were significantly higher in sepsis thanin SIRS and in patients with bacterial localized infections. Thediscrimination and diagnostic accuracy of NGAL weresupported by ROC curve analysis. At the cut-off value of 300ng/mL, NGAL identified sepsis with high sensitivity andspecificity. In sepsis, NGAL was strictly correlated with PCTand MR-proADM. Stratifying subjects of the study population infive different classes on the basis of PCT, NGAL values werecorrelated with PCT in each class. NGAL, like MR-proADM, was significantly correlated with APACHE II as well as withSOFA scores of disease severity.Conclusions: Data of the study demonstrated the advantagederived from the combined use of the three markers PCT, MRproADMand NGAL in septic patients’ management and thecentral role of NGAL in SA-AKI diagnosis and prognosis.
Plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Combination with Procalcitonin (PCT) and MR-proadrenomedullin (MR-proADM) in the Diagnosis and Prognosis of Sepsis and Sepsis Associated Acute Kidney Injury
Angeletti S;Ciccozzi M;
2016-01-01
Abstract
Objective: Early recognition of sepsis is important to preventprogression to severe sepsis and septic shock conditions thatmay lead to Acute Kidney Injury (AKI). In the present study, thecombined measurement of plasma biomarkers NGAL, PCT andMR-proADM in the diagnosis and prognosis of sepsis andsepsis associated acute kidney injury (SA-AKI) was evaluated.Methods: Twenty patients with sepsis, 18 with localizedinfections, 17 with SIRS and 24 healthy donors have beenconsecutively enrolled: NGAL, PCT and MR-proADM weremeasured at admission (T=0), at 24 hours (T=1) and in thethird or fifth day of antibiotic therapy (T=3-5) in septic patientsand as a single determination (T=0) in the remaining subjects.PCT and MR-proADM were measured by a time-resolvedamplified emission method (Kryptor; Brahms AG, Hennigsdorf,Germany). NGAL was measured by turbidimetric immunoassay(NGAL Test, Bio Porto Diagnostics, Denmark). The creatininewas determined using an enzymatic IDM tracedspectrophotometric method (Siemens, Healthcare DiagnosticsInc., Italy). Data were analyzed using the statistical packageMedCalc 13.2.2.0.Results: NGAL values were significantly higher in sepsis thanin SIRS and in patients with bacterial localized infections. Thediscrimination and diagnostic accuracy of NGAL weresupported by ROC curve analysis. At the cut-off value of 300ng/mL, NGAL identified sepsis with high sensitivity andspecificity. In sepsis, NGAL was strictly correlated with PCTand MR-proADM. Stratifying subjects of the study population infive different classes on the basis of PCT, NGAL values werecorrelated with PCT in each class. NGAL, like MR-proADM, was significantly correlated with APACHE II as well as withSOFA scores of disease severity.Conclusions: Data of the study demonstrated the advantagederived from the combined use of the three markers PCT, MRproADMand NGAL in septic patients’ management and thecentral role of NGAL in SA-AKI diagnosis and prognosis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
