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Neutrophil gelatinase-associated lipocalin in dehydrated patients: a preliminary report

DOI: 10.1186/1756-0500-4-435

Keywords: dehydration, Neutrophil Gelatinase-Associated Lipocalin, Ngal, biomarker, acute kidney injury

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Abstract:

A total of twelve patients presented with symptoms of mild dehydration defined by history of diarrheas or vomiting and orthostatic (postural) hypotension and an age and sex matched group of twelve control patients were included. The two groups of patients did not seem to differ in basic clinical and laboratory parameters. Serum Ngal was higher in dehydrated patients when compared to control group (Ngal = 129.4 ± 25.7 ng/mL vs 60.6 ± 0.4 ng/mL, p = 0.02). Ngal was not correlated with age, hemoglobin, white blood cell count, red blood cell count, urea or creatinine.The presence of elevated Ngal levels in dehydrated patients may suggest its role as a very sensitive biomarker in even minimal and "silent" prerenal kidney dysfunctionRenal impairment may be the result of a variety of renal or systemic diseases and may lead to renal failure [1]. Although the gold standard of renal failure's diagnosis is serial measurements of serum creatinine (Cr) [2,3], this biomarker is of little clinical importance in very early stages of renal disease. A novel biomarker, neutrophil gelatinase-asssociated lipocalin (Ngal), has been promising in evidencing renal impairment, even when changes in serum Cr level are undetectable [1].In order to explore the possible role of Ngal in subclinical renal dysfunction, such as renal hypoperfusion, we prospectively evaluated twelve patients aged>18 years with medical history suggesting mild dehydration, accompanied by orthostatic hypotension. A group of twelve apparently healthy individuals with no history of dehydration and no evidence of orthostatic hypotension were treated as controls. Ethical approval was obtained by the Ethics Committee of the "401 General Army Hospital" in Athens, Greece and all patients gave informed consent.Dehydrated and controls were similar in age and gender (75% males in each group) and in terms of basic laboratory tests (Hemoglobin; Hb, White blood cells; Wbc, Red blood cells; Rbc, Urea; Ur and Cr). Although no laborator

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