Urinary Neutrophil Gelatinase-Associated Lipocalin NGAL and proteinuria predict severity of acute kidney injury in Puumala virus infectionReport as inadecuate




Urinary Neutrophil Gelatinase-Associated Lipocalin NGAL and proteinuria predict severity of acute kidney injury in Puumala virus infection - Download this document for free, or read online. Document in PDF available to download.

BMC Infectious Diseases

, 15:464

First Online: 27 October 2015Received: 19 February 2015Accepted: 06 October 2015

Abstract

BackgroundNephropathia 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.

MethodsWe 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.

ResultsThe 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.

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

KeywordsHantavirus Nephropathia epidemica Acute kidney injury NGAL Neutrophil Gelatinase-Associated Lipocalin Puumala virus infection Hemorrhagic fever with renal syndrome AbbreviationsAKIAcute kidney injury

AKINAcute kidney injury network

CKD-EPIChronic kidney disease epidemiology collaboration

CRPC-reactive protein

EREmergency room

NENephropathia epidemica

PCTProcalcitonin

PUUVPuumala virus

ROCReceiver operating characteristic

uACRUrinary albumin creatinine ratio

uNGALUrinary Neutrophil Gelatinase-Associated Lipocalin

Electronic supplementary materialThe online version of this article doi:10.1186-s12879-015-1180-9 contains supplementary material, which is available to authorized users.

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Author: Hanno Bunz - Peter Weyrich - Andreas Peter - Dorothea Baumann - Otto Tschritter - Martina Guthoff - Robert Beck - Gerhard 

Source: https://link.springer.com/







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