Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) and proteinuria predict severity of acute kidney injury in Puumala virus infection

BMC Infectious Diseases

Robert Wagner³  Nils Heyne⁴  Hans-Ulrich Häring³  Ferruh Artunc⁴  Gerhard Jahn¹  Robert Beck¹  Martina Guthoff⁴  Otto Tschritter⁴  Dorothea Baumann⁴  Andreas Peter²  Peter Weyrich⁴  Hanno Bunz⁴ 

[1] Institute of Medical Virology and Epidemiology of Viral Diseases, Eberhard Karls University, Tübingen, Germany;Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen (IDM), Tübingen, Germany;German Center for Diabetes Research (DZD), Tübingen, Germany;Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, University Hospital of the Eberhard Karls University, Tübingen, Germany

关键词: Hemorrhagic fever with renal syndrome;    Puumala virus infection;    Neutrophil Gelatinase-Associated Lipocalin;    NGAL;    Acute kidney injury;    Nephropathia epidemica;    Hantavirus;   

Others  :  1232749
DOI  :  10.1186/s12879-015-1180-9

 received in 2015-02-19, accepted in 2015-10-06,  发布年份 2015

【 摘 要 】

Background

Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome (HFRS) that is caused by the Puumala virus. Periodic outbreaks have been described in endemic areas, with a substantial number of previously healthy individuals developing acute kidney injury (AKI). There is a considerable diversity in the clinical course of the disease, and few patients require renal replacement therapy.

Methods

We tested whether urinary neutrophil gelatinase associated lipocalin (uNGAL), urine albumin/creatinine ratio (uACR), urine protein/creatinine ratio (uPCR), urine dipstick protein, C-reactive protein, procalcitonin, leukocyte and platelet count, determined on admission to the hospital, can predict the severity of AKI. Sixty-one patients were analyzed during admission in the emergency department.

Results

The variables most strongly associated with peak plasma creatinine concentration were uNGAL (β = 0.70, p <0.0001), uPCR (β = 0.64, p = 0.001), uACR (β = 0.61, p = 0.002), and dipstick proteinuria (β = 0.34, p = 0.008). The highest AUC-ROC to predict stage 3 AKI according to the acute kidney injury network’s (AKIN) classification was seen for uNGAL (0.81, p = 0.001).

Conclusion

uNGAL accurately predicts the severity of AKI in NE. This could help emergency room physicians predict disease severity and allow for initial risk stratification.

【 授权许可】

   
2015 Bunz et al.

【 图 表 】

Fig. 1.

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