Serum Creatinine & Urinary NGAL superior to MDRD for diagnosing AKI Without prior baseline creatinine data
Researchers from the University of Tokyo have reported that urinary neutrophil gelatinase-associated lipocalin or NGAL at ICU admission is superior to the Modification of Diet in Renal Disease (MDRD) approach in diagnosing Acute Kidney Injury when the real baseline creatinine value is unavailable.
According to the results of this research study, implementing urinary NGAL and serum creatinine at admission in CART analysis developed the novel AKI diagnostic criteria for those without baseline renal function data. This demonstrated better diagnostic performance.
The study is published in the Journal of Critical Care.
It is already known that for AKI diagnosis, estimating the baseline renal function of patients without prior creatinine measurement is crucial.
Adding more data, the present study incorporated AKI biomarkers into a new AKI diagnosis rule when no premorbid baseline is available in their prospective observational study. They measured NGAL, L-type fatty acid-binding protein (L-FABP).
This study was conducted in an adult intensive care unit (ICU).
The study results are:
- Researchers enrolled 243 patients were enrolled.
- CART analysis composed a decision tree for AKI diagnosis. (serum creatinine and urinary NGAL were predictors).
- The novel decision rule was superior to the imputation strategy based on the MDRD equation regarding the misclassification rate (13.0% vs 29.6%).
- The net benefit of the decision rule exceeded the MDRD approach in a threshold probability range of 25% and higher.
Concluding further, the novel diagnostic rule incorporating serum creatinine and urinary NGAL at ICU admission showed superiority to the MDRD approach in AKI diagnosis without baseline renal function data.
Further reading:
https://www.sciencedirect.com/science/article/abs/pii/S0883944123000618?via%3Dihub
