Plasma neutrophil gelatinase-associated lipocalin and kidney function decline and kidney disease-related clinical events in older women

Wai Lim, Joshua Lewis, G. Wong, R. Teo, E.M. Lim, E. Byrnes, Richard Prince

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    © 2015 S. Karger AG, Basel. Background: It is still unclear whether serum neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of renal tubular injury, is a prognostic marker for the progression of chronic kidney disease (CKD) in the general population. Methods: A prospective-cohort study of 1,245 women aged ≥70 from the general population. Associations between plasma NGAL and change in 5-year estimated glomerular filtration rate (eGFR), rapid renal decline and 10-year risk of acute or chronic renal disease-related hospitalisations and/or mortality were examined. Results: Compared to women with above-median plasma NGAL of 76.5 ng/l, women with below-median plasma NGAL had a 9.3% reduction in eGFR over a 5-year period. Among women with above-median plasma NGAL, there was over a 1.7-fold increased risk of rapid renal decline (eGFR decline of >3 ml/min/year) (adjusted odds ratio 1.76, 95% CI 1.003, 3.102, p = 0.049). Compared to women with baseline eGFR of 2, women with above-median plasma NGAL experienced over a 2.5-fold increased risk of renal disease events at 10 years (hazard ratio 2.55, 95% CI 1.13, 5.78, p = 0.025) after adjustment of age, hypertension and diabetes. Addition of plasma NGAL in participants with eGFR of 2 significantly improved the accuracy in predicting the 10-year risk of renal disease events (adjusted area-under-curve receiver operator characteristics without and with NGAL 0.64 and 0.71, respectively; p = 0.027) and reclassified 13% of women who experienced renal disease events into the higher risk categories (p = 0.03). Conclusion: Plasma NGAL is of modest clinical utility in predicting the renal function decline and risk of renal disease-related clinical events, particularly those with mild to moderate CKD.
    Original languageEnglish
    Pages (from-to)156-164
    JournalAmerican Journal of Nephrology
    Volume41
    Issue number2
    DOIs
    Publication statusPublished - 2015

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    Kidney Diseases
    Kidney
    Glomerular Filtration Rate
    Chronic Renal Insufficiency
    Lipocalin-2
    Population
    Area Under Curve
    Hospitalization
    Cohort Studies
    Biomarkers
    Odds Ratio
    Prospective Studies
    Hypertension
    Mortality
    Wounds and Injuries
    Serum

    Cite this

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    title = "Plasma neutrophil gelatinase-associated lipocalin and kidney function decline and kidney disease-related clinical events in older women",
    abstract = "{\circledC} 2015 S. Karger AG, Basel. Background: It is still unclear whether serum neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of renal tubular injury, is a prognostic marker for the progression of chronic kidney disease (CKD) in the general population. Methods: A prospective-cohort study of 1,245 women aged ≥70 from the general population. Associations between plasma NGAL and change in 5-year estimated glomerular filtration rate (eGFR), rapid renal decline and 10-year risk of acute or chronic renal disease-related hospitalisations and/or mortality were examined. Results: Compared to women with above-median plasma NGAL of 76.5 ng/l, women with below-median plasma NGAL had a 9.3{\%} reduction in eGFR over a 5-year period. Among women with above-median plasma NGAL, there was over a 1.7-fold increased risk of rapid renal decline (eGFR decline of >3 ml/min/year) (adjusted odds ratio 1.76, 95{\%} CI 1.003, 3.102, p = 0.049). Compared to women with baseline eGFR of 2, women with above-median plasma NGAL experienced over a 2.5-fold increased risk of renal disease events at 10 years (hazard ratio 2.55, 95{\%} CI 1.13, 5.78, p = 0.025) after adjustment of age, hypertension and diabetes. Addition of plasma NGAL in participants with eGFR of 2 significantly improved the accuracy in predicting the 10-year risk of renal disease events (adjusted area-under-curve receiver operator characteristics without and with NGAL 0.64 and 0.71, respectively; p = 0.027) and reclassified 13{\%} of women who experienced renal disease events into the higher risk categories (p = 0.03). Conclusion: Plasma NGAL is of modest clinical utility in predicting the renal function decline and risk of renal disease-related clinical events, particularly those with mild to moderate CKD.",
    author = "Wai Lim and Joshua Lewis and G. Wong and R. Teo and E.M. Lim and E. Byrnes and Richard Prince",
    year = "2015",
    doi = "10.1159/000380831",
    language = "English",
    volume = "41",
    pages = "156--164",
    journal = "American Journal of Nephrology",
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    publisher = "S Karger AG",
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    Plasma neutrophil gelatinase-associated lipocalin and kidney function decline and kidney disease-related clinical events in older women. / Lim, Wai; Lewis, Joshua; Wong, G.; Teo, R.; Lim, E.M.; Byrnes, E.; Prince, Richard.

    In: American Journal of Nephrology, Vol. 41, No. 2, 2015, p. 156-164.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Plasma neutrophil gelatinase-associated lipocalin and kidney function decline and kidney disease-related clinical events in older women

    AU - Lim, Wai

    AU - Lewis, Joshua

    AU - Wong, G.

    AU - Teo, R.

    AU - Lim, E.M.

    AU - Byrnes, E.

    AU - Prince, Richard

    PY - 2015

    Y1 - 2015

    N2 - © 2015 S. Karger AG, Basel. Background: It is still unclear whether serum neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of renal tubular injury, is a prognostic marker for the progression of chronic kidney disease (CKD) in the general population. Methods: A prospective-cohort study of 1,245 women aged ≥70 from the general population. Associations between plasma NGAL and change in 5-year estimated glomerular filtration rate (eGFR), rapid renal decline and 10-year risk of acute or chronic renal disease-related hospitalisations and/or mortality were examined. Results: Compared to women with above-median plasma NGAL of 76.5 ng/l, women with below-median plasma NGAL had a 9.3% reduction in eGFR over a 5-year period. Among women with above-median plasma NGAL, there was over a 1.7-fold increased risk of rapid renal decline (eGFR decline of >3 ml/min/year) (adjusted odds ratio 1.76, 95% CI 1.003, 3.102, p = 0.049). Compared to women with baseline eGFR of 2, women with above-median plasma NGAL experienced over a 2.5-fold increased risk of renal disease events at 10 years (hazard ratio 2.55, 95% CI 1.13, 5.78, p = 0.025) after adjustment of age, hypertension and diabetes. Addition of plasma NGAL in participants with eGFR of 2 significantly improved the accuracy in predicting the 10-year risk of renal disease events (adjusted area-under-curve receiver operator characteristics without and with NGAL 0.64 and 0.71, respectively; p = 0.027) and reclassified 13% of women who experienced renal disease events into the higher risk categories (p = 0.03). Conclusion: Plasma NGAL is of modest clinical utility in predicting the renal function decline and risk of renal disease-related clinical events, particularly those with mild to moderate CKD.

    AB - © 2015 S. Karger AG, Basel. Background: It is still unclear whether serum neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of renal tubular injury, is a prognostic marker for the progression of chronic kidney disease (CKD) in the general population. Methods: A prospective-cohort study of 1,245 women aged ≥70 from the general population. Associations between plasma NGAL and change in 5-year estimated glomerular filtration rate (eGFR), rapid renal decline and 10-year risk of acute or chronic renal disease-related hospitalisations and/or mortality were examined. Results: Compared to women with above-median plasma NGAL of 76.5 ng/l, women with below-median plasma NGAL had a 9.3% reduction in eGFR over a 5-year period. Among women with above-median plasma NGAL, there was over a 1.7-fold increased risk of rapid renal decline (eGFR decline of >3 ml/min/year) (adjusted odds ratio 1.76, 95% CI 1.003, 3.102, p = 0.049). Compared to women with baseline eGFR of 2, women with above-median plasma NGAL experienced over a 2.5-fold increased risk of renal disease events at 10 years (hazard ratio 2.55, 95% CI 1.13, 5.78, p = 0.025) after adjustment of age, hypertension and diabetes. Addition of plasma NGAL in participants with eGFR of 2 significantly improved the accuracy in predicting the 10-year risk of renal disease events (adjusted area-under-curve receiver operator characteristics without and with NGAL 0.64 and 0.71, respectively; p = 0.027) and reclassified 13% of women who experienced renal disease events into the higher risk categories (p = 0.03). Conclusion: Plasma NGAL is of modest clinical utility in predicting the renal function decline and risk of renal disease-related clinical events, particularly those with mild to moderate CKD.

    U2 - 10.1159/000380831

    DO - 10.1159/000380831

    M3 - Article

    VL - 41

    SP - 156

    EP - 164

    JO - American Journal of Nephrology

    JF - American Journal of Nephrology

    SN - 0250-8095

    IS - 2

    ER -