ecancermedicalscience

Clinical Study

Plasma neutrophil gelatinase-associated lipocalin and factors related to acute kidney injury and mortality in critically ill cancer patients

14 Feb 2019
Bertha M Córdova-Sánchez, Erika B Ruiz-García, Alicia López-Yañez, Mireya Barragan-Dessavre, Andoreni R Bautista-Ocampo, Abelardo Meneses-García, Angel Herrera-Gómez, Silvio A Ñamendys-Silva

Rationale: Acute kidney injury (AKI) is a frequent complication in critically ill cancer patients.

Objectives: To assess plasma neutrophil gelatinase-associated lipocalin (NGAL) levels and risks factors associated with AKI and mortality.

Methods: We recruited 96 critically ill cancer patients and followed them prospectively. Plasma NGAL levels were determined at intensive care unit (ICU) admission and at 48 hours. We generated receiver operating characteristic curves to assess the ability of NGAL to predict AKI. Logistic regression analysis was performed to determine risks factors associated with AKI. Cox-regression analysis was performed to evaluate 6-month mortality.

Measurements and main results: From 96 patients, 60 (63%) developed AKI and 33 (55%) were classified as stages 2 and 3. In patients without AKI at admission, plasma NGAL levels revealed an area under the curve (AUC) = 0.522 for all AKI stages and an AUC = 0.573 for stages 2 and 3 AKI (85% sensitivity and 67% specificity for a 50.66 ng/mL cutoff). We identified sequential organ failure assessment (SOFA) score (without renal parameters) at admission as an independent factor for developing stages 2 and 3 AKI, and haemoglobin as a protective factor. We observed that metastatic disease, dobutamine use and stage 3 AKI were independent factors associated with 6-month mortality.

Conclusions: In our cohort of critically ill cancer patients, NGAL did not predict AKI. SOFA score was a risk factor for developing AKI, and haemoglobin level was a protective factor for developing AKI. The independent factors associated with 6-month mortality included metastatic disease, dobutamine use, lactate and stage 3 AKI.

Article metrics: 436 views
211
225

Related Articles

Richard Ofori-Asenso, Oyepeju Ogundipe, Akosua Adom Agyeman, Ken Lee Chin, Mohsen Mazidi, Zanfina Ademi, Marie Louise De Bruin, Danny Liew
Frederic Ivan Ting, Danielle Benedict Sacdalan, Honey Sarita Abarquez, Arnold John Uson
Milan Terzic, Melanie Norton, Sanja Terzic, Gauri Bapayeva, Gulzhanat Aimagambetova
Barbara Buonomo, Roberto Orecchia, Federica Tomao, Lino Del Pup, Alex Garcia-Faura, Fedro A Peccatori
Suleiman Ghunaim, Ghina Ghazeeri, Dalia Khalife, Hatem A Azim Jr