Plasma NGAL similarly predicts acute kidney injury in sepsis and nonsepsis

Aim: Plasma NGAL is released in sepsis irrespective of acute kidney injury (AKI). The current study investigated the effect of sepsis on the diagnostic value of NGAL for AKI. Materials & methods: In 700 intensive care unit admissions, NGAL was measured at four time points (<24 h) following admission. Results: In total, 663 admissions were included in the final analysis, of which 80 patients had sepsis (12%). AKI occurred in 22% of the patients without and 66% with sepsis. NGAL levels were higher in non-AKI patients with sepsis compared with non-AKI patients without sepsis at all time points (p = 0.03 or lower). In patients with AKI a similar difference was observed (p < 0.001). The area under the curve for AKI was unaffected by the presence of sepsis (0.76 in sepsis vs 0.78 in nonsepsis; p = 0.72); however, the optimal test cutoff values were higher in the former. Conclusion: Sepsis enhances the production of plasma NGAL in critically ill adult patients irrespective of the presence of AKI. However, the diagnostic test accuracy for AKI is unaffected by sepsis, although optimal cutoff values are elevated.

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