Prognostic utility of neutrophil gelatinase associated lipocalin in cardiac ICU: A prospective study

Our study aims to evaluate the role of neutrophil gelatinase associated lipocalin (NGAL) as an early surrogate marker in predicting acute kidney injury (AKI) and mortality in cardiac ICU patients. The study was conducted at SRN Hospital, excluding those with known renal diseases. Out of 152 patients, 56 developed AKI (cases) and 96 were our controls. Higher NGAL was associated with increased mortality rates (P ¼ 0.0201 and 0.0255 for serum and urinary NGAL respectively). Our study concluded that NGAL measurement at admission may be a boon in improving the outcome of cardiac ICU patients

Predictive value of kidney injury markers for early DGF in kidney transplant recipients / 器官移植

Objective To evaluate the predictive values of serum neutrophil gelatinase-associated lipocalin (NGAL), urine NGAL, serum cystatin C (Cys-C) and serum creatinine (Scr) for early delayed graft function (DGF) in kidney transplant recipients. Methods Clinical data, blood and urine samples of 159 kidney transplant recipients were collected. All recipients were divided into the DGF group (n=42) and immediate graft function (IGF) group (n=117) according to the incidence of DGF. Clinical data of all recipients were analyzed. The changes of serum NGAL, urine NGAL, Cys-C and Scr levels were statistically compared between two groups. The predictive values of different markers for early DGF were assessed. Results Among 159 kidney transplant recipients, DGF occurred in 42 cases with an incidence rate of 26.4%. There were statistically significant differences in donor age, cold ischemia time of donor kidney and complement-dependent cytoxicity (CDC) between the two groups(all P < 0.05). Within postoperative 2 weeks, the serum NGAL levels in the DGF group were higher than those in the IGF group (all P < 0.05). The Cys-C, Scr and urine NGAL levels in the DGF group were higher compared with those in the IGF group within 3 weeks after kidney transplantation(all P < 0.001). Serum NGAL, urine NGAL, Cys-C and Scr levels had certain predictive values for early DGF in kidney transplant recipients. Cys-C yielded the highest predictive value with a cut-off value of 4.73 mg/L, sensitivity of 0.833, specificity of 0.812 and area under the curve (AUC) of 0.895. Conclusions Cys-C has higher predictive value for early DGF in kidney transplant recipients compared with serum NGAL, urine NGAL and Scr.

Normothermic machine perfusion of kidney and ischemia-free kidney transplantation / 器官移植

To increase the utilization rate of expanded criteria donor (ECD) kidney, the kidney preservation methods have been ever advancing in recent years. The application of normothermic machine perfusion (NMP) promotes the preservation, evaluation and repair of ex vivo donor kidneys and accelerates the innovation of surgical approaches of kidney transplantation. Ischemia-free kidney transplantation (IFKT), which initiated by Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, keeps the blood flow and oxygen supply of the donor kidney with NMP machine during the entire process of acquisition, preservation and transplantation, thereby fundamentally avoiding ischemia-reperfusion injury (IRI) of the donor kidney and reducing the risk of delayed graft function (DGF) and acute rejection after surgery. In this article, recent progresses upon the kidney NMP, surgical procedures and short-term outcomes of IFKT were reviewed, aiming to provide reference for enhancing the utilization rate of ECD donor kidney and resolving the issue of organ shortage.

Risk factors of acute kidney injury in patients with diabetic nephropathy and the prognostic value of urine NGAL / 中华内分泌外科杂志

Objective:To study the risk factors of acute kidney injury in patients with diabetic nephropathy and the prognostic value of urinary neutrophil gelatinase associated lipocalin (NGAL) .Methods:The data of 80 patients with diabetic nephropathy in the First Hospital of Shanxi Medical University from Mar. 2016 to Dec. 2020 were retrospectively studied. According to the random selection of numbers + artificial arrangement, they were divided into observation group and control group according to the presence or absence of acute kidney injury (AKI) . The observation group included patients with diabetic nephropathy complicated by acute kidney injury, and the control group included patients with diabetic nephropathy. The urinary albumin/creatinine ratio (ACR) , blood routine, left ventricular ejection fraction (LVEF) , NGAL, etc. were compared between the two groups. The correlation and influencing factors of acute kidney injury in patients with diabetic nephropathy and age, eGFR, severe infection, antibiotics, heart failure, respiratory failure, ACR, LVEF, and NGAL were studied. At the same time, the prognostic value of urinary NGAL was analyzed.Results:Single factor screening: There was no significant difference in gender or body weight between the two groups ( P>0.05) . However, there were differences in age, epidermal growth factor receptor (eGFR) , severe infection, antibiotics, heart failure, respiratory failure, ACR, LVEF, and NGAL ( P<0.05) . Correlation: Acute kidney injury in patients with diabetic nephropathy was very weakly correlated with gender, age, and body weight, moderately correlated with eGFR, heart failure, respiratory failure, ACR, and LVEF, and highly correlated with NGAL, severe infection, and antibiotics. Risk factors: The independent risk factors for acute kidney injury in patients with diabetic nephropathy included severe infection, eGFR, antibiotics, ACR, LVEF, and NGAL. The prognostic value of urinary NGAL: AUC=0.967, standard error 0.021, Youden index 0.967, sensitivity 0.967, specificity 1, and zero cutoff point 30.00. Conclusion:The main influencing factors of DN complicated with AKI are severe infection, eGFR, antibiotics, ACR, LVEF, NGAL, and urinary NGAL has prognostic value for DN complicated with AKI, and it is worthy of clinical application.

Upregulation of Megalin, Cubilin, NGAL mRNA expression in kidney may represent tubular injury and apoptosis in chronic condition of rat diabetic model

@#Introduction: Diabetes mellitus (DM) leads to microvascular injury development and produces diabetes nephropathy (DN) with proteinuria, tubular injury, apoptosis and autophagy with upregulation of Bax, BASP and mTORC-1. Megalin, Cubilin and Neutrophil Gelatinase Associated Lipocalin (NGAL) play role in acute pathological condition of kidney injury, however its expression in chronic and slowly progressive kidney injury such as DN has not been elucidated yet. This study focuses upregulation of Megalin, Cubilin and NGAL in association with tubular injury and apoptosis in DN condition. Materials and methods: Diabetic condition was performed with intraperitoneal injection of Streptozotocin 60 mg/kg body weight (BW) in Sprague Dawley rats (2 months old, n=24), and were kept for 1, 2, and 4 months (DM1, DM2, and DM4, respectively). Control group was injected with NaCl 0.9%. Serum glucose level and proteinuria score were assessed, furthermore tubular injury score was quantified based on Periodic-Acid Schiff (PAS) staining. Reverse Transcriptase-PCR (RT-PCR) was carried out for NGAL, Megalin, Cubilin, m-TOR, Bax, and BASP-1 mRNA expression. Data were analyzed using SPSS 22 software. Results: DM led to kidney injury in this model with significant higher glucose level, proteinuria and tubular injury, especially in DM4 group which represented chronic phase of DN and CKD. These findings associated with upregulation of Megalin,Cubilin and NGAL mRNA expression in DM groups, especially in DM4 group. DM4 group also revealed higher expression of Bax, BASP and mTOR mRNA expression which demonstrated apoptosis. Conclusion: Megalin, Cubilin and NGAL upregulation may represent tubular injury and apoptosis as progression of DN.

Clinical application of biomarkers in DCD donor kidney perfusate for predicting delayed graft function after renal transplantation / 器官移植

Objective To explore the feasibility of biomarkers in static cold storage (SCS) perfusate of donor kidney from donation after cardiac death (DCD) for predicting delayed graft function (DGF) after renal transplantation. Methods Clinical data of 64 recipients and 47 donors undergoing DCD renal transplantation were retrospectively analyzed. All recipients were divided into the DGF group (n=7) and immediate graft function (IGF) group (n=57) according to the incidence of postoperative DGF in the recipients. The levels of neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP), interleukin -18(IL-18) and kidney injury molecule-1 (KIM-1) in the SCS perfusate were statistically compared between two groups, and the correlation with DGF was analyzed. The predictive value of each biomarker in the occurrence of DGF in recipients after renal transplantation was analyzed. Results The incidence of DGF in the recipients undergoing DCD renal transplantation was 11% (7/64). The NGAL level in the donor kidney perfusate of the DGF group was significantly higher than that in the IGF group (P=0.009). The NGAL level in the donor kidney perfusate was positively correlated with the incidence of DGF in recipients after renal transplantation (r=0.430, P < 0.001). The receiver operating characteristic (ROC) curve analysis showed that the increased levels of NGAL and KIM-1 in the perfusate yielded certain predictive value for DGF in recipients after renal transplantation (both P < 0.05). The area under the curve (AUC) of combined detection of NGAL and KIM-1 for predicting DGF in recipients after renal transplantation was 0.932 [95% confidence interval (CI) 0.850-1.000]. The sensitivity was calculated as 1.000 and 0.754 for the specificity (P < 0.05). Conclusions The NGAL level in the SCS perfusate of DCD donor kidney is associated with the occurrence of DGF in recipients after renal transplantation. Combined detection of NGAL and KIM-1 levels in the perfusate may accurately predict the occurrence of DGF in recipients after renal transplantation.

Short-term renal and metabolic effects of low dose vildagliptin treatment added-on insulin therapy in non-proteinuric patients with type 2 diabetes: open-label randomized prospective study

ABSTRACT Objective The aim of this randomized comparative study was to assess renal and metabolic effects of vildagliptin in insulin-treated type 2 diabetes (T2DM) patients without overt chronic kidney disease. Subjects and methods We randomized 47 insulin-treated non-proteinuric patients with satisfactory controlled T2DM and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m 2 either to continue insulin therapy (control) or to receive combined insulin-vildagliptin treatment (VIG group). We assessed eGFR using serum creatinine (eGFRcreat), cystatin C (eGFRcys), and both (eGFRcreat-cys), and urinary creatinine-adjusted excretion of albumin (UACR), type IV collagen (uCol IV/Cr), and neutrophil gelatinase-associated lipocalin (uNGAL/Cr) at baseline and after 6 months of treatment. Results Study groups were comparable in terms of age and sex (60.1 ± 6.1 years and 42.9% men in control group vs. 60.8 ± 5.2 years and 39.1% in VIG group). After 6 months of treatment, there were no significant changes in main assessed parameters in control group. VIG group demonstrated significant decrease in HbA1c, diastolic blood pressure, frequency of hypoglycemia, and high-sensitivity C-reactive protein level as compared to the changes in control group. While eGFRcreat, UACR, and uNGAL/Cr showed no significant changes after vildagliptin addition, eGFRcys, eGFRcreat-cys, and uCol IV/Cr changed significantly in comparison with control group (+7.0% [3.7;13.3]; +5.1% [1.4;8.5]; -32,8% [-55.8;-24.4], respectively, p < 0.01 each). Correlation and regression analysis revealed glucose-independent pattern of these changes. Conclusion Addition of vildagliptin to ongoing insulin therapy in patients with T2DM was associated with a reduction in uCol IV/Cr and an increase in eGFRcys and eGFRcreat-cys, independent of T2DM control parameters.

Research progress on molecular markers related to the donor kidney injury from organ donation after citizen's death / 器官移植

Shortage of donor kidney is a major problem in renal transplantation. Accurate evaluation of donor kidney function may reduce the organ rejection rate and save more patients with uremia. Compared with pathological examination, detection of circulating molecular markers is more convenient in clinical application. In this article, the research progress on the markers of kidney injury, such as serum creatinine, serum cystatin C (Cys-C), neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP), mitochondrial DNA (mtDNA), kidney injury molecule-1(KIM-1) and interleukin -18 (IL-18), were briefly reviewed.

Association of serum neutrophil gelatinase associated lipocalin (NGAL) levels with preeclampsia

Background: Preeclampsia is a systemic disorder that affects multiple organs and is characterized by the new onset of hypertension and proteinuria or end-organ dysfunction or both in the second half of pregnancy. NGAL is a 25-KDa protein of the lipocalin family and is considered to be a novel biomarker for ischemic injury. The objective of this study is to compare the levels of serum NGAL in preeclamptic patients and gestational age matched normotensive controls.Methods: The study design is case control study in which pregnant women with preeclampsia (n=40) are selected as cases. Cases were selected from pregnant women attending OG-OPD and IP satisfying the inclusion criteria and not coming under exclusion criteria. 0.5ml of blood was collected in vacutainers and was centrifuged at 3500rpm for 10 minutes. The serum thus separated was aliquoted into smaller plain containers and stored at -20 degree Celsius for analysis. The urine sample was also collected. Controls were also selected from the OP patients.Results: In present study, the serum NGAL ranged from 40-900ng/ml in cases and from 110-795ng/ml in controls. There is no difference in NGAL between cases and control. The correlation coefficients between the NGAL levels and other parameters like maternal age, gestational age, systolic Blood pressure, diastolic Blood pressure, uric acid levels, urine PCR are also not statistically significant.Conclusions: Serum NGAL levels are not significantly elevated in patients with preeclampsia when compared with the normotensive controls and also there is no significant correlation between serum NGAL levels and other assessed parameters.

Effect of xinmailong injection on NGAL, hs-cTnT and RAAS in elderly patients with type 2 cardio-renal syndrome / 实用医学杂志

Objective Observation of the effects of Xinmailong injection on NGAL, hs-cTnT and RAAS in elderly patients with type 2 cardio-renal syndrome (CRS) , and EvaluatIon of the clinical efficacy and safety.Methods A total of 86 elderly patients who were collected from November 2015 to February 2017 were diagnosed as type 2 CRS in our department of geriatrics. According to the random number table method, they were randomly divided into two groups. Control group (43 cases) were treated with conventional medical therapy and xinmailong group (43 cases) were treated with xinmailong injection with a dose of 5 mg/kg twice a day for 15 days. The value of sneutrophil gelatin-associated apolipoprotein (NGAL) , hypersensitive troponin T (hs-cTnT) , brain natriuretic peptide (BNP) , plasma renin activity (PRA) , and angiotensin Ⅱ (Ang Ⅱ) , aldosterone (ALD) , left ventricular ejection fraction (LVEF) , six-minute walking test and other indicators were measured before and after treatment. Results After treatment, the value of NGAL, hs-cTnT, BNP, PRA, AngⅡ and ALD decreased in both groups, the value of LVEF and six-minute walking distance increased compared with those before treatment (P <0.05); The above indicators in the xinmailong group experienced a more significant alteration than in control group in the same period (P < 0.05); no side effect occurred in both two groups during the experiment. Conclusion Xinmailong injection can reduce the levels of NGAL, hs-cTnT and BNP in elderly patients with type 2 cardio-renal syndrome, improve heart and kidney function, and have curative positive effect and good safety. This study underlined the mechanism of Xinmailong injection may be related to the inhibition of RAAS activity.

Value of combined detection of urine NGAL and KIM-1 in the early diagnosis of contrast-induced nephropathy / 国际检验医学杂志

Objective To explore and analyze the effect and value of combined detection of urine neutrophil gelatin-associated apolipoprotein (NGAL) and kidney injury molecule 1 (KIM-1) in the early diagnosis of contrast-induced nephropathy.Methods The clinical data of 116 patients with coronary heart disease who received coronary intervention treatment in our hospital in 2017 were collected with forward-looking research methods.The patients were divided into the non-contrast-induced nephropathy group (control group, n=90) and the contrast-induced nephropathy group (observation group, n=26) according to the occurrence of contrast-induced nephropathy.The levels of serum creatinine, serum urea nitrogen, urine NGAL and KIM-1 were compared at different time points between the two groups.Results From 2 days after surgery, the serum creatinine levels were increased significantly (P＜0.05).The serum creatinine levels at 2 days after surgery (102.43±20.31) μmol/L and 3 days after surgery (107.22±25.13) μmol/L in the observation group were significantly higher than those in the control group[ (92.89±16.74) μmol/L, (91.97±15.38) μmol/L];The serum urea nitrogen levels in the observation group were increased significantly from 12 hafter surgery (P＜0.05);the serum urea nitrogen levels of the observation group at 12 h, 1 d, 2 dand 3 dafter surgery were significantly higher than those of the control group (P＜0.05);The urine NGAL levels at 4 and 12 hour and 1 and 2 days after surgery in the observation group were significantly higher than those in the control group;The KIM-1 levels at 1 day after surgery (5.14±0.96) μg/L and 2 days after surgery (5.58±1.33) μg/L in the observation group were significantly higher than those in the control group [ (3.58±1.23) μg/L, (3.64±1.15) μg/L], and the differences were statistically significant (P＜0.05).Pearson correlation analysis showed that there was a positive correlation between urinary NGAL at 4 hours postoperatively and serum creatinine at2 days postoperatively (r=0.784, P=0.000), and positively correlated with serum urea nitrogen level at 1 day postoperatively (r=0.811, P=0.000).The KIM-1 level at 1 day postoperatively was positively correlated with the serum creatinine level at 2 days postoperatively (r=0.596, P=0.000), and positively correlated with the serum urea nitrogen level at 2 days postoperatively (r=0.644, P=0.000).ROC curve analysis showed that the area under curve (AUC) of urine NGAL was 0.917[95％confidence interval (CI) :0.884-0.951], the sensitivity was 86.74％, and the specificity was 93.92％;AUC of KIM-1 was 0.842 (95％CI:0.755-0.901), the sensitivity was 81.16％, and the specificity was 83.47％.Conclusion Urine NGAL and KIM-1 are biochemical markers that can early react to the impairment of renal function, and have positive value in the early diagnosis of contrast-induced nephropathy.

Early diagnostic value of urinary NGAL for postoperative acute kidney injury in patients with acute Stanford type A aortic dissection / 中国胸心血管外科临床杂志

@#Objective     To investigate the early diagnostic value of urinary neutrophil gelatinase-associated lipocalin (NGAL) for acute kidney injury (AKI) after acute Stanford type A aortic dissection. Methods     From January 2018 to December 2018, the clinical data of 50 patients who underwent open surgery for acute Stanford type A aortic dissection were analyzed in Nanjing First Hospital. Urine specimens were collected before and 2 hours after the aortic dissection surgery. Patients were divided into an AKI group (n=27) and a non-AKI group (n=23) according to the Kidney Disease Improving Global Outcomes criteria. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of urine NGAL.  Results    The incidence of postoperative AKI was 54.00% (27/50). There was a statistically significant difference between the two groups in serum creatinine concentration at 2 hours after surgery and urinary NGAL concentration before the surgery (P<0.05). The area under ROC curve of preoperative urinary NGAL concentration was 0.626. When cut-off value was 43 ng/mL, the sensitivity was 40.7%, specificity was 95.7%. The area under ROC curve of urinary NGAL concentration at 2 hours after surgery was 0.655, and when the cut-off value was 46.95 ng/mL, the sensitivity was 63.0%, specificity was 78.3%.  Conclusion     Urine NGAL can predict postoperative AKI in patients with acute Stanford type A aortic dissection, but its value is limited.

Prevention of contrast-induced nephropathy by Cordyceps among patients undergoing percutaneous coronary procedures using intravenous contrast

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> This study aimed to determine the efficacy and safety of Cordyceps in preventing occurrence of contrast-induced nephropathy (CIN) among patients undergoing CA / PCI using IV contrast compared to standard therapy.</p><p style="text-align: justify;"><strong>METHODS:</strong> We searched Medline, Embase, Cochrane database, and Google Scholars for RCTs involving the use of Cordyceps in contrast-induced nephropathy. We used the search keywords "Cordyceps" and "contrast-induced nephropathy" with the Boolean operator "AND" and filtering search results to include only randomized controlled trials and clinical trials. Three trials were found which satisfied all the inclusion criteria and none of the exclusion criteria.</p><p style="text-align: justify;"><strong>RESULTS:</strong> No patient developed clinical renal failure, adverse reactions, or side effects with the Cordyceps arm. CIN occurred in 26 out of 285 patients. The incidence of CIN was less in the Cordyceps group compared to the standard therapy group (p < 0.05, CI 0.20, 1.00).</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Cordyceps shows a trend towards prevention of CIN and a decrease in biomarkers for acute kidney injury. More studies with larger populations need to be performed to further clarify its preventive effects.</p>

Expression and role of neutrophil gelatinase-associated lipocalin (NGAL) signaling pathways in the early stage of vein graft restenosis of a pig model / 中国胸心血管外科临床杂志

@#Objective     To investigate the expression of neutrophil gelatinase-associated lipocalin (NGAL) signaling pathways in the early stage of porcine vein graft restenosis, and to explore the possible role and mechanism in the early vein graft restenosis after coronary artery bypass surgery. Methods     We selected 18 ordinary healthy pigs weighing 25-30 kg and collected samples of the vein graft of pigs at the preoperation and postoperative days 7, 14 and 30. Hematoxylin-eosin (HE) staining and Masson staining, immunohistochemical method were used to observe the neointimal hyperplasia, the migration of smooth muscle cells and and vascular remodeling of the vein bypass graft. The expression changes of NGAL, matrix metalloprotenase (MMP)9, MMP2 and tissue inhibitor of metalloproteinase (TIMP)1 in different periods of the vein bypass graft was tested. Results     By HE and Masson staining, with the passing of modeling time, degradation of collagen matrix in the vein graft, gradually thickening of muscle fibers and the migration to the inner membrance and vascular remodeling caused the vascular stenosis. By immunohistochemistry, NGAL, MMP9  and MMP2 of normal vein in the model were seldom expressed and even did not express. At 14 days after the modeling, NGAL expression in the membrane layer of blood vessels began to appear, peaked at postoperative 30 days, and began to appear in the inner membrance. MMP9, MMP2 expression began to appear at postoperative 7 days, peaked at postoperative 14 days, and tended to decline at postoperative 30 days. TIMP1 expression was less in normal vascular walls and at the 14 days after the modeling, expression peaked in the vein graft. Conclusion     NGAL, MMP9, MMP2 and TIMP1 may be involved in the formation of early vascular graft restenosis. NGAL as initiator, results in the expression of MMP9 and MMP2, and participates in the degradation of collagen matrix and the migration of smooth muscle cells in vein grafts. TIMP1 as a negative factor, may play an important role in maintaining their own balance.

Comparison the efficacy and safety of lithotriptors with different focus size and energy in the management of renal calculi / 实用医学杂志

Objective To compare the clinical efficacy and safety of wide-focus high energy lithotriptor with narrow-focus low energy lithotriptor treating renal calculi. Methods A prospective study was conducted to compare both modalities for the management of renal calculi.Stone formers were randomly enrolled into two groups. Group A was managed with wide-focus high energy lithotriptor,while group B was managed with the other. Urine samples were collected to detect neutrophil gelatinase-associated lipocalin(NGAL)and α1-microglobulin(α1-MG)levels before and after SWL. Results 60 were randomized to the group A and 60 to group B. There was no significant difference between two groups in stone free rate and complication rate.For stones more than 10 mm,re-treat rate(11.1%vs 39.1%,P=0.021)was lower and complication rate(25.9%vs 4.3%,P=0.038)was higher in group A. There had a larger increase of NGAL in group A(P < 0.001)after SWL. Conclusion SWL with both lithotriptors are effective and safe for renal stones.Wide-focus high energy lithotripsy was associated with lower re-treat rate and higher complication rate for stones more than 10 mm.NGAL may play a potential role in the evalua-tion of SWL induced early renal injury.

Study on Combined Determination Plasma NGAL,Cys C and Urinary NAG/Crea for the Diagnosis of Early Diabetic Nephropathy / 现代检验医学杂志

Objective To investigate the value of plasma neutrophil gelatinase-associated lipocalin (NGAL),cystatin C (Cys C) and the ratio of urinary N-acetyl-beta-D-glucosaminidase to creatinine (NAG/Crea) combined determination in the diagnosis of early diabetic nephropathy.Methods Collected 67 cases of patients with type 2 diabetes hospitalized in the First Affiliated Hospital of Kunming Medical University from December 2016 to February 2017.According to the value of UALB/Crea was divided into two groups:Diabetic urinary microalbumin normal group (UALB/Crea＜30 mg/gCrea) had 35 patients and early diabetic nephropathy group (namely the trace albuminuria group,UALB/Crea 30 ～ 300 mg/gCrea) had 32 patients.Other selected 20 normal volunteers as control group,compared with a medical group to gather all the staff of the clinical data,using automatic biochemical analyzer detected the plasma NGAL,Cys C and urine NAG/Crea,and adopted the receiver-operating characteristic (ROC) curve of the detection index was analyzed.Results ①Plasma NGAL,Cys C and urinary NAG/Crea of diabetic nephropathy patients was significantly higher than those of healthy control group (Z=-5.740 ～-5.386,P＜0.05).②The areaunder receiver operating characteristic (ROC) curve of plasma NGAL,Cys C and urine NAG/Crea were 0.858,0.911 and 0.714.Conclusion Plasma NGAL,Cys C and urinary NAG/Crea combined determination have a higher value for early diagnosis of diabetic nephropathy.

The experimental research of Neutrophil Gelatinase-associated Lipocalin(NGAL) siRNA encapsulated by UAC on NGAL gene silence in colon cancer cells / 中国生化药物杂志

Objective To explore the effect of NGAL knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC).MethodsNGAL siRNA encapsulated by UAC and chitosan (CTS) respectively, which were then used to transfect human colon cancer cell lines HT29.The expression level of NGAL protein were detected by Enzyme Linked Immunosorbent Assay(ELISA).ResultsThe ELISA study revealed that the expression level of NGAL protein in UAC group(average 0.583μg/L) was significantly lower than in CTS group (average 0.772μg/L) and control group(average 1.071μg/L) (P<0.05).ConclusionThe NGAL expression of mRNA and protein in HT29 cells could be down-regulated by siRNA encapsulated by UAC.

Clinical Study on NGAL and Iron Status in Patients with Chronic Renal Anemia / 现代检验医学杂志

Objective To evaluated the association between the NAGL and the chronic kidney disease (CKD) patients with iron status,which was occurred iron scarcity for CKD patient in clinical.Methods 154 CKD patients were included in this study.Serum neutrophil gelatinase-related lipid transport protein(NGAL) were detected in anemia group and non-anemia group of chronic kidney disease.The NGAL,univariate correlation and multivariate regression analysis,as well as ROC curve analysis,were used to assess and compared the diagnostic potential of NGAL,ferritin,EPO and Tfr (transferrin receptor) in CKD patients after analyzing the patient's iron status.Results NGAL levels were markedly higher in CKD patients with anemia than CKD patients without anemia.In the analysis,NGAL was inverse correlated with hemoglobin,hematocrit,MCV,MCH,serum iron and TSAT(correlation relation was-0.36,-0.32,-0.26,-0.31,-0.38,-0.3,respectively).ROC analysis was employed to assess and compare the diagnostic potentials of the NGAL,ferritin,EPO,and Tfr (transferritin receptor) in identifying this condition among CKD patients.The NGAL showed that the area under the curve of iron deficiency in CKD patients (AUC) was 0.713,with good sensitivity and specificity (58.6％ vs 74.7 ％).Conclusion NGAL might be proposed as a new tool in the assessment of iron deficiency and in the management of iron therapy for CKD patients.

Investigation on the Serum NGAL Reference Range of Healthy Populations in Xi'an / 现代检验医学杂志

Objective To establish serum NGAL reference range of healthy populations in Xi'an Area.Methods 2 665 cases (aged 6 to 95 years old,male 1 370,female 1 295) of health-check people were collected from March 2014 to October 2016 in Medical Examination Center of Shaanxi Provincial People's Hospital,and 682 cases (aged 0 to 6 years old,male 356,female 326) were collected from preschool children of prevention.Serum NGAL concentration of them were analysed by immunoturbidimetry method with the Automatic Biochemical Analysis Assembly Line of Beckman-AU5800,and the detection data for statistical analysis.Then established the reference range of serum NGAL population of different age and different sex in Xi'an.Results The serum NGAL levels in healthy subjects showed a skewed distribution,which were preschool children under 6 years of age 37.66±23.12 ng/ml,6～15 years 39.25±25.34 ng/ml,16～49 years 46.68±27.06 ng/ml,and 50～ 69 years 57.82±29.13 ng/ml.Compared the first two with the latter,there was a significant difference (t=0.589,P＜ 0.05).The serum NGAL levels of over 70 years were 61.87 ± 32.64 ng/ml,and there was a significant difference between the ages of 15 and 49 and over 70 years (t=8.529,P＜0.01).At the same time,the serum NGAL was closely correlated with age (r=0.298,P＜0.01).But there was no significant difference in serum NGAL level between male and female (t=0.263～0.542,all P＞0.05).87ng/ml was the upper limit of the reference value for the age of 50 years.Conclusion The level of serum NGAL was related to age and increased with age,but not with gender.

Effects of piperazine ferulate tablets combined with Huangqi injection on β2-microglobulin, NGAL and clinical efficacy in patients with acute renal failure / 中国生化药物杂志

Objective To investigate the effects of piperazine ferulate tablets combined with Huangqi injection on β2-microglobulin,NGAL and clinical efficacy in patients with acute renal failure.Methods A total of 56 patients with acute renal failure from June 2012 to October 2015 in our hospital were collected and randomly divided into the experimental group and the control group with 28 cases in each group.All patients before the treatment of conventional care,diuretics and vasodilators to increase the patient's serum protein and vitamins,so that patients with the body's pH,moisture and electrolyte balance,and gave hemodialysis and low molecular heparin anticoagulant therapy.Patients in the control group were treated on the base of the conventional therapy withastragalus injection 20mL/time,one time a day,intravenous drip,treatment of four weeks; patients in the experimental group were treated on the base of the control group with piperazine ferulate tablet 200mg/time,three times/day,treatment of four weeks.After treatment,compared patients' β2 microsphere protein,NGAL and KIM-1 levels.Results There was no significant difference in the survival rate between the two groups.Compared with before treatment,β2 microsphere protein,NGAL and KIM-1 levels in two groups were lower(P<0.05);Compared with control group,β2 microsphere protein,NGAL and KIM-1 levels in the experimental group were lower(P<0.05).Conclusion Piperazine ferulate tablets combine with astragalus injection in the treatment of patients with acute renal failure have a better clinical curative effect,speculate that the mechanism is relate to reduce β2 microsphere protein,NGAL and KIM-1 levels.