Neutrophil gelatinase–associated lipocalin: A promising biomarker for detecting cardiac surgery–associated acute kidney injury

Acute kidney injury is a common and significant problem that occurs in a wide variety of clinical settings. Cardiac surgery–associated acute kidney injury continues to be a well-recognized complication of cardiac surgery with associated morbidity and mortality. A lack of early biomarkers for acute kidney injury has prevented timely interventions to mitigate the effects of acute kidney injury. Because serum creatinine is not a timely marker of acute kidney injury, it cannot be used to institute potentially effective therapies to treat acute kidney injury in patients during phases when the injury is still potentially reversible. Neutrophil gelatinase–associated lipocalin has been identified as a promising biomarker for early detection of acute kidney injury. Several studies have shown that neutrophil gelatinase–associated lipocalin levels increase significantly in patients with acute kidney injury 24 to 48 hours before an increase in serum creatinine is detectable. Recent studies suggest that measurements of neutrophil gelatinase–associated lipocalin levels in patients at risk for cardiac surgery–associated acute kidney injury can facilitate its early diagnosis and allow clinicians to implement therapeutic adjustments that have the potential to reverse renal cellular damage and minimize further kidney injury.

CTSNet classification: 18

Abbreviations and Acronyms: AKI, acute kidney injury, AUC, area under the curve, CIN, contrast-induced nephropathy, CPB, cardiopulmonary bypass, CSA, cardiac surgery–associated, GFR, glomerular filtration rate, ICU, intensive care unit, IL, interleukin, KIM, kidney injury molecule, NGAL, neutrophil gelatinase–associated lipocalin, SCr, serum creatinine