Comparative assessment of neutrophil gelatinase-associated lipocalin [NGAL] and cystatin C as early biomarkers for early detection of renal failure in patients with hypertension

Hypertension is one the most common causes of chronic kidney disease [CKD]. One of the major concerns in hypertensive patients is early detection of renal disorders. In the past, serum creatinine [Scr] concentration was used as a marker of kidney function, but it proffers a late reflection of reduced glomerular filtration rate. Cystatin C and neutrophil gelatinase-associated lipocalin [NGAL] have been recently proven to be useful for quantification of CKD. Therefore, we compared the diagnostic value of NGAL with cystatin C and creatinine to evaluate kidney function in hypertensive patients. In this study, 42 hypertensive patients and 30 healthy volunteers were recruited. Serum cystatin C [Scys C] and plasma NGAL were measured using ELISA method. Creatinine, urea, hemoglobin, fibrinogen, and C-reactive protein were measured according to the routine methods. Estimated glomerular filtration rate [eGFR] was considered as the gold standard method [cut-off value of < 78 ml/min/1.73 m[2]. In the patient group, plasma NGAL, cystatin C, and creatinine were all significantly correlated with eGFR, and plasma NGAL correlated best with eGFR. Receiver-operating characteristics analysis indicated that plasma NGAL was a better indicator than creatinine and cystatin C for predicting a GFR < 78 ml/min/1.73 m[2]. The sensitivity and specificity for NGAL were 96% and 100%, for cystatin C were 92% and 60% and for creatinine were 76% and 47%, respectively. Plasma NGAL demonstrated a higher diagnostic value to detect kidney impairment in the early stages of CKD as compared to Scys C and Scr in hypertensive patients

Assessment of Neutrophil gelatinase-associated lipocalin [NGAL] as an early biomarker for detection of renal impairment in hypertensive patients

Chronic kidney disease [CKD] is probably the most important problem of public health in advanced countries. Kidneys are often damaged as a result of high blood pressure. One of our main concerns in patients with hypertension is early detection of kidney disorders. The routine biomarkers such as creatinine have some limitation for this purpose, however recent studies suggest plasma NGAL to be a better marker. Therefor in this study we assessed the diagnostic value of plasma NGAL and compared it with serum creatinine in hypertensive patients. This study was performed on 42 hypertensive patients and 30 healthy Volunteer, both with normal serum creatinine and urea concentration who referred to Shohada Tajrish Hospital, plasma NGAL were measured subsequently using ELISA method and eGFR was considered as the gold standard method[cut off value of<78ml.min.1.73m[2]]. mean NGAL level was significantly higher in patients in comparison to control group. The sensitivity and specificity were 96% and 100% respectively for plasma NGAL[>/=32.2 ng/ml] compared with 76% and 47% for serum creatinine [>0.97 mg/dl]. Our findings indicate that NGAL is a better indicator of kidney impairment in the early stages of CKD as compared with serum creatinine in hypertensive patients

Evaluation of some factors affecting the risk of kidney damage in patients with hypertension

Chronic kidney disease [CKD] is an increasing cause of morbidity and mortality worldwide. Prospective data on risk factors for CKD are few. Hypertension is one of the risk factors for CKD. In the past serum creatinine concentration was used as marker of kidney function but it proffers a late reflection of reduced glomerular filtration rate[GFR], which limits its ability to detect impaired kidney function. Cystatin C and NGAL have recently been proven useful to quantitate CKD. Therefore in this study, we assessed the effect of some risk factors on reduction of estimated glomerular filtration rate [eGFR] in patients with high blood pressure. This study was performed on 42 hypertensive patients and 30 healthy volunteers, both with normal serum creatinine and urea concentration. In this study, we measured serum cystatin C and Plasma NGAL. Serum creatinine and urea levels of the patients were measured after an overnight fasting. . Estimated glomerular filtration rate [eGFR] was considered as the gold standard method .Serum cystatin C and plasma NGAL were measured using commercially available human ELISA kits. Logistic regression and T-test were used for statistical analysis. The results of logistic regression showed that among the variables studied, plasma levels of NGAL, age and duration of hypertension were significantly associated with the eGFR<78[P<0.05]. Our findings suggest that, increased levels of NGAL, age and duration of hypertension predicts a higher odds of impaired renal function