RESUMEN
PURPOSE: Plasma neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker that shows correlation with the severity of acute infection and acute kidney injury (AKI). This study was conducted in order to determine the predictive value of NGAL in the emergency department for predicting the severity of acute pyelonephritis. METHODS: A retrospective study was conducted between October 2012 and May 2013. A total of 46 patients diagnosed with acute pyelonephritis were enrolled in this study. Plasma NGAL was measured upon admission to the hospital and clinical and laboratory data, CT were collected. Based on these data, we classified our patients according to two groups (high NGAL group: NGAL > or =400 ng/mL vs low NGAL group: NGAL <400 ng/mL) and we evaluated the correlation between clinical data, laboratory data, and CT. RESULTS: Among the 46 patients, there were 45 female patients and the mean age was 59.0+/-20.4 years. Statistically significant differences in CT grades, hospital stay, SIRS, and shock were observed between the NGAL groups. The area under the ROC curve for CT severity by NGAL was 0.890(95% CI, 0.796-0.985), which was better than CRP and MDRD GFR. NGAL levels showed correlation with CRP (r=0.508; p<0.001) and MDRD GFR (r=-0.766, p<0.001). CONCLUSION: NGAL is a useful specific biomarker predicting severity of acute pyelonephritis.