The NGAL Test

 

The NGAL Test – first diagnostic acute kidney injury biomarker which can be measured in both human urine and plasma.

Acute kidney injury (AKI), previously known as acute renal failure, represents a medical emergency and encompasses a wide range of injury to the kidneys. Acute kidney injury is a rapid deterioration of renal function, resulting in an inability to maintain fluid, electrolyte and acid-base balance. AKI increase morbidity and mortality and due to the severity of acute kidney injury the healthcare costs are significant. As a result of this increased efforts into identifying new acute kidney injury biomarkers can be seen, as biomarkers addressing the need for earlier diagnosis of AKI would ultimately save lives, raise quality of life for patients worldwide and save costs for the healthcare system.

NGAL (neutrophil gelatinase-associated lipocalin, lipocalin-2, siderocalin) is a novel biomarker for diagnosing acute kidney injury (AKI). Under normal conditions NGAL levels are low in urine and plasma but rise sharply from basal levels in response to kidney injury to reach diagnostic levels within a very short time - as much as 24 hours or more before any significant rise in serum creatinine. NGAL  is a small protein expressed in neutrophils and certain epithelia, including the renal tubules. Renal expression of NGAL is dramatically increased in kidney injury from a variety of causes, and NGAL is released into both urine and plasma. NGAL levels rise within 2 hours of the insult, making NGAL an early and sensitive biomarker of kidney injury.

Clinical research have proven that NGAL levels identify patients with AKI before any diagnostic change in serum creatinine. The existing clinical evidence points to several benefits of NGAL testing such as -

» Early diagnosis of AKI to allow earlier initiation of appropriate management
» RIsk stratification of AKI
» Prediction of clinical outcomes (dialysis, in-hospital death, length of hospital stay, mortality)
» Monitor response to therapy
» Lower hospitalization costs

The NGAL Test is a particle-enhanced turbidimetric immunoassay for the quantitative determination of neutrophil gelatinase-associated lipocalin (NGAL) in human urine, EDTA plasma or heparin plasma on automated clinical chemistry analyzers. NGAL measurements are useful in the diagnosis of acute kidney injury which may lead to acute renal failure. The test can be run on most automated clinical chemistry analyzers. Measuring NGAL in urine or plasma gives you information on AKI status that you need for rapid decision making e.g. in the following settings:

» Kidney transplantation - predictive evaluation
» Cardiopulmonary bypass surgey - monitoring
» Emergency room - triage tool
» Intensive care - monitoring
» Intravenous contrast agents - assessing nephrotoxicity

NGAL - Key scientific literature

 

NGAL and AKI publications

The following listed publications supports the seriuosness and costly effects of AKI and the positive healthcare outcome, when introducing NGAL as an early biomarker for AKI.

The early AKI risk assessement made possible by using NGAL is highly supported.

 Find a selection of relevant publications - full list click here.

NGAL / AKI: Links and resources

NGAL / AKI: Further knowledge

Ever since NGAL as a diagnostic biomarker was linked to AKI assessement, NGAL has been given a central role in many international AKI initiatives.

The connection between NGAL and AKI diagnostics has led to a wealth of forums and informational resources strengthening the foucs on the subject. To provide an overview and easy access to all these freee available resources, we have collected the most recent high impact links for your access divided into the following groups. Just click below and access overview.

The NGAL Test Reagent Kit

Particle-enhanced Turbidimetric Immunoassay (PETIA)

The NGAL Test Reagent Kit

Cat.No. ST001

Application: Roche Cobas, Siemens ADVIA etc.

Further information