Urinary Neutrophil Gelatinase-Associated Lipocalin for Assessment of Acute Kidney Injury in Patients with Liver Cirrhosis | ||
| The Egyptian Journal of Hospital Medicine | ||
| Volume 101, Issue 1, October 2025, Pages 5121-5127 PDF (273.67 K) | ||
| DOI: 10.21608/ejhm.2025.458569 | ||
| Abstract | ||
| Background: Urine neutrophil gelatinase-associated lipocalin (uNGAL) has been recognized as a promising diagnostic indicator for acute kidney injury (AKI). It is a 25-kDa polypeptide that is significantly elevated and excreted during the onset of AKI. Objective: To determine the utility of uNGAL as a preliminary marker for the detection of AKI in patients with cirrhosis. Patients and Methods: This cross-sectional observational study was performed on 60 patients with liver cirrhosis, who were allocated into three equal groups: group 1 included patients without ascites, group 2 included ascitic patients without kidney impairment, and group 3 composed of ascitic participants with recently developed kidney impairment. Results: The Child-Pugh score was significantly elevated in group 2 and group 3 when related with group 1 (p = 0.005 and p < 0.001, respectively). The End-Stage Liver Disease (MELD) score was also markedly elevated in group 3 relative to both group 1 and group 2 (p < 0.001 and p = 0.003, respectively). uNGAL demonstrated strong diagnostic performance for identifying AKI, with a statistically significant result (p < 0.001) and AUC of 0.960. At a cutoff value of >350.4 ng/mL, uNGAL showed 90.0% sensitivity, 92.5% specificity, PPV of 85.7%, and NPV of 94.9%. uNGAL was significantly elevated in Group 2 and Group 3 than Group 1 (P value=0.005 and <0.001 respectively) and elevated in Group 3 than Group 2 (P value<0.001). Conclusion: In participants with cirrhosis, uNGAL can significantly be used as an indicator for diagnosis of AKI. | ||
| Keywords | ||
| uNGAL; AKI; Liver Cirrhosis; Hepatorenal Syndrome; Acute Tubular Necrosis | ||
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