패혈증 환자의 급성 신손상 발생 예측에 있어 혈장 Neutrophil Gelatinase- Associated Lipocalin 측정의 유용성 = Plasma Neutrophil Gelatinase-associated Lipocalin is an Early Marker of Acute Kidney Injury

다국어 초록 (Multilingual Abstract)

Purpose: Serum creatinine is a late marker of acute kidney injury (AKI). We assessed the diagnostic value of plasma neutrophil gelatinase-associated lipocalin (NGAL) for predicting acute kidney injury in emergency department patients with sepsis.
Methods: This was a prospective observational study of adult sepsis patients. Plasma NGAL levels were measured upon admission to the hospital, and clinical data and serum creatinine were collected daily during the hospital stay. The primary outcome measure was the occurrence of AKI based on criteria from the Acute Kidney Injury Network (AKIN).
Results: A total of 178 patients were included, with 13patients (7.3%) that developed AKI during their hospital stay; 9 and 4 were classified as AKIN stage 1 and 2,respectively. Six patients out of the 13 with AKI died. Mean plasma NGAL levels were 277 ng/mL in patients without AKI and 852 ng/mL in patients with AKI. The area under the receiver operating characteristic curve was 0.883 (95%confidence interval 0.803 to 0.964), the sensitivity was 91.7%, and the specificity was 80.5% for the prediction of AKI (using a cut-off value of 353.5 ng/mL).
Conclusion: Plasma NGAL is a useful early marker that predicts the development of AKI in adult sepsis patients.

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