NGAL in AKI

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Ala Ali

Saúde e medicina

Biomarkers: AMI versus AKI Multiple Therapies 50% ↓ Mortality Need early biomarkers of AKI for improved understanding, early treatment and better outcomes Thursday, July 1, 2010 Period Acute Myocardial Infarction Acute Kidney Injury 1960s LDH 1970s CPK, myoglobin 1980s CK-MB 1990s Troponin T 2000s Troponin I

Biomarkers: AMI versus AKI Multiple Therapies 50% ↓ Mortality Supportive Care High Mortality Need early biomarkers of AKI for improved understanding, early treatment and better outcomes Thursday, July 1, 2010 Period Acute Myocardial Infarction Acute Kidney Injury 1960s LDH Serum creatinine 1970s CPK, myoglobin Serum creatinine 1980s CK-MB Serum creatinine 1990s Troponin T Serum creatinine 2000s Troponin I Serum creatinine

Role of Biomarkers in AKI ,[object Object],[object Object],[object Object],[object Object],Devarajan, Semin Nephrol 27:637-651, 2007 Devarajan, Contrib Nephrol 160:1-16 , 2008 Thursday, July 1, 2010

Phase 2/3: NGAL as an Early AKI Biomarker ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],AKI = 50% or greater increase in serum creatinine from baseline DGF = dialysis requirement within the first week after transplant Thursday, July 1, 2010 Biomarker Name Cardiopulmonary Bypass (CPB) Contrast induced Nephropathy Sepsis or ICU Setting Kidney Transplant (tx) NGAL (ROC AUC) (ref) 2 hr post CPB 2 days pre AKI 0.91-0.99 (1-5) 2 hr post contrast 1-2 days pre AKI 0.92 (6, 7) 2 days pre AKI 0.78 (8, 9) 12 hr post tx 2-3 days pre DGF 0.90 (10, 11)

Thursday, July 1, 2010 Dr. Ala A. Sh. Ali The Medical City Department of Nephrology , Dialysis , and Renal Transplantation Baghdad Iraq

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NGAL in AKI

1. Thursday, July 1, 2010

2. Thursday, July 1, 2010

3. Biomarkers: AMI versus AKI Multiple Therapies 50% ↓ Mortality Need early biomarkers of AKI for improved understanding, early treatment and better outcomes Thursday, July 1, 2010 Period Acute Myocardial Infarction Acute Kidney Injury 1960s LDH 1970s CPK, myoglobin 1980s CK-MB 1990s Troponin T 2000s Troponin I

4. Biomarkers: AMI versus AKI Multiple Therapies 50% ↓ Mortality Supportive Care High Mortality Need early biomarkers of AKI for improved understanding, early treatment and better outcomes Thursday, July 1, 2010 Period Acute Myocardial Infarction Acute Kidney Injury 1960s LDH Serum creatinine 1970s CPK, myoglobin Serum creatinine 1980s CK-MB Serum creatinine 1990s Troponin T Serum creatinine 2000s Troponin I Serum creatinine

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