Diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL) as an early biomarker for detection of renal failure in hypertensives: a case-control study in a regional hospital in Ghana

Renal failure is one of the most serious vascular effects of hypertension. For better therapy and prevention of complications, early kidney disease identification in these patients is absolutely essential. However, current studies have proposed plasma Neutrophil Gelatinase Associated Lipocalin (pNGA...

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Published in:	BMC nephrology Vol. 24; no. 1; p. 114
Main Authors:	Danquah, Mark, Owiredu, William K B A, Jnr, B A Eghan, Serwaa, Dorcas, Odame Anto, Enoch, Peprah, Maxwell Owusu, Obirikorang, Christian, Fondjo, Linda A
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 26-04-2023 BioMed Central BMC
Subjects:	Acute-Phase Proteins Biomarkers Blood Glucose Blood pressure Care and treatment Case-Control Studies Chronic illnesses Chronic kidney failure Complications and side effects Creatinine Diabetes Epidemiology Fasting Gelatinase Ghana Glomerular Filtration Rate Health aspects Hospitals Humans Hypertension Hypertension - complications Hypertension - diagnosis Hypertension - epidemiology Kidney diseases Laboratories Leukocytes (neutrophilic) Lipocalin Lipocalin-2 Lipocalins Measurement Nephrology Nephropathy Neutrophil gelatinase associated lipocalin Neutrophils Normal distribution Patients Prevention Proto-Oncogene Proteins Renal failure Renal function Renal Insufficiency - complications Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - epidemiology Risk factors Statistical analysis Womens health Ghana Africa Creatinine Hypertension Neutrophil gelatinase associated lipocalin Renal failure
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Summary:	Renal failure is one of the most serious vascular effects of hypertension. For better therapy and prevention of complications, early kidney disease identification in these patients is absolutely essential. However, current studies have proposed plasma Neutrophil Gelatinase Associated Lipocalin (pNGAL) to be a better biomarker comparative to serum creatinine (SCr). This study assessed the diagnostic utility of plasma neutrophil gelatinase-associated lipocalin (pNGAL) as a biomarker for early nephropathy diagnosis in hypertensive individuals. This hospital-based case-control study comprised 140 hypertensives and 70 healthy participants. A well-structured questionnaire and patient case notes were used to document relevant demographic and clinical information. 5 ml of venous blood sample was taken to measure fasting blood sugar levels, creatinine, and plasma NGAL levels. All data were analyzed using the Statistical Package for Social Sciences (SPSS release 20.0, copyrite©SPSS Inc.) and a p-value < 0.05 was considered statistically significant. In this study the plasma neutrophil gelatinase-associated lipocalin (NGAL) levels were significantly higher in cases compared to controls. Hypertensive cases also had significantly higher waist-circumference compared to the control group. The median fasting blood sugar level was significantly higher in cases compared to controls. This study established the use of Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft and Gault formula (CG) as the most accurate predictive equations for assessing renal dysfunction. The threshold for NGAL above which renal impairment can be assessed was found to be 109.4 ng/ml (sen-91%, spec. - 68%), 120 ng/ml (sen- 100%, spec- 72%) and 118.6 ng/ml (sen- 83%, spec- 72%) for MDRD, CKD-EPI and CG equations respectively. The prevalence of CKD was 16.4%, 13.6% and 20.7% respectively using the MDRD, CKD-EPI and CG. From this study, pNGAL is a better indicator of kidney impairment in the early stages of CKD as compared with sCr in general hypertensive population.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2369 1471-2369
DOI:	10.1186/s12882-023-03120-6