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

ABSTRACT

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