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01-12-2015 | Nephrology - Original Paper

Serum neutrophil gelatinase-associated lipocalin is associated with cardiovascular events in patients with chronic kidney disease

Authors: Yalcin Solak, Mahmut Ilker Yilmaz, Dimitrie Siriopol, Mutlu Saglam, Hilmi Umut Unal, Halil Yaman, Mahmut Gok, Hakki Cetinkaya, Abduzhappar Gaipov, Tayfun Eyileten, Sebahattin Sari, Ali Osman Yildirim, Halil Zeki Tonbul, Suleyman Turk, Adrian Covic, Mehmet Kanbay

Published in: International Urology and Nephrology | Issue 12/2015

Abstract

Background

Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known as a novel and early marker of acute kidney injury (AKI). Recent data suggest that NGQueryAL is not only a marker of AKI, but also an important player in the vascular remodeling, atherosclerotic plaque stability and thrombus formation. We conducted this study to investigate the association of serum NGAL levels with fatal and composite (fatal and non-fatal) cardiovascular events (CVE) in a cohort of patients with stage 1–5 CKD.

Methods

This was an observational cohort study in which serum NGAL was obtained from 298 CKD (stages 1–5) patients. Fatal and composite CVE were recorded for a median 41 months. We examined alteration of serum NGAL through CKD groups as well as association with inflammatory markers. We also performed a Cox regression analysis to determine the association of NGAL with predefined clinical outcomes.

Results

The median value of NGAL was 50.5 ng/mL (IR 47.6–54.9 ng/mL), and higher NGAL values were recorded in diabetic patients. In a multiple linear regression model, including all univariate associates of NGAL, only log eGFR, log hs-CRP and log HDL cholesterol maintained an independent association with log NGAL. During the observational period, 30 patients died due to cardiovascular causes and 69 non-fatal CVE were registered. In the fully adjusted model, we observed a 2.08-fold increase in the risk of fatal CVE and a 1.50-fold increase in the risk of fatal and non-fatal CVE for each increment of 1 SD in log NGAL values.

Conclusions

This is the first study that shows that serum NGAL is associated with cardiovascular events (fatal and non-fatal) in patients with CKD, independently of traditional risk factors, renal function and inflammation.

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Title: Serum neutrophil gelatinase-associated lipocalin is associated with cardiovascular events in patients with chronic kidney disease
Authors: Yalcin Solak
Mahmut Ilker Yilmaz
Dimitrie Siriopol
Mutlu Saglam
Hilmi Umut Unal
Halil Yaman
Mahmut Gok
Hakki Cetinkaya
Abduzhappar Gaipov
Tayfun Eyileten
Sebahattin Sari
Ali Osman Yildirim
Halil Zeki Tonbul
Suleyman Turk
Adrian Covic
Mehmet Kanbay
Publication date: 01-12-2015
Publisher: Springer Netherlands
Published in: International Urology and Nephrology / Issue 12/2015
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-015-1136-4

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