• Jae Yun Ahn, Mi Jin Lee, Jun Seok Seo, Daihai Choi, and Jeong Bae Park.
• a Department of Emergency Medicine , School of Medicine, Kyungpook National University , Daegu , Republic of Korea ;
• Clin Toxicol (Phila). 2016 Jan 1; 54 (2): 127-33.

ContextAcute kidney injury (AKI) is a serious complication in intoxicated patients. Recently, a new biomarker - neutrophil gelatinase-associated lipocalin (NGAL) - was used to predict AKI in patients who were critically ill or had sepsis.ObjectiveTo evaluate the utility of plasma NGAL as an early predictor of AKI in adults with acute poisoning.Materials And MethodsThis retrospective, observational, cohort study was conducted between December 2013 and November 2014. A total of 157 consecutive adult patients who presented to the emergency department (Level 1 regional center) of Kyungpook National University Hospital, a tertiary teaching hospital in Daegu, Korea, within 24 h of poisoning were included. Initial plasma NGAL levels and laboratory parameters were concurrently measured upon hospital arrival. AKI was defined according to Acute Kidney Injury Network criteria. Development of AKI was predicted using plasma NGAL levels and by analyzing the area under the receiver operating characteristic curve (AUC).ResultsThe overall rate of AKI was 14.6% (n = 23). Plasma NGAL levels in the AKI group were higher than those in the non-AKI group (median, 310 vs. 86 ng/mL; p < 0.001). Additionally, baseline NGAL levels allowed for better prediction of AKI than initial creatinine levels. The AUC of plasma NGAL was 0.895 (95% confidence interval [CI]: 0.832-0.941), with a cut-off value of 227 ng/mL (sensitivity, 76.2%; specificity, 95.8%). Plasma NGAL had a higher predictive capacity for AKI than serum creatinine (AUC 0.741, 95% CI: 0.662-0.810), base deficit (AUC 0.795, 95% CI: 0.701-0.870), lactate (AUC 0.781, 95% CI: 0.690-0.856), and anion gap (AUC 0.636, 95% CI: 0.535-0.730).ConclusionPlasma NGAL may serve as a good predictor of AKI in cases of adult poisoning.

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