Abstract
Introduction: Acute kidney injury (AKI) makes a reversible accumulation of nitrogen
products. This waste product is partly determined by serum creatinine level but it is not
reliable during hypotension. However, neutrophil gelatinase-associated lipocalin (NGAL), as
a new biomarker, shows an obvious increase even at hypotensive status.
Objectives: The presented study was designed to evaluate NGAL as a right biomarker for AKI
early diagnosis and consequent appropriate therapies.
Patients and Methods: In this study, 25 healthy individuals and 47 cases out of 60 primarily
admitted patients with low blood pressure were evaluated for NGAL level using blood
samplings, health documents as well as analysis of questionnaires data. The group’s sizes were
determined based on AKI and hypotension risk rates. Exclusion and inclusion criteria were
firmly considered to avoid major confounding factors.
Results: AKI was found in 20 cases out of 47 hypotensive patients. NGAL levels were about
243.35 ± 105.74 ng/dL (Mean ± SD) in AKI and 192.32 ± 64.31 ng/dL (Mean ± SD) in non-AKI
hypotensive patients that showed a significant difference (P=0.037) at the first 6 hours. There
was no significant difference between hospitalization duration and NGAL level (P=0.616).
Conclusion: NGAL is important diagnostic protein in the early stages of AKI while there was
no creatinine increasing. On the other hand, NGAL level during early 6 hours of hypotension
introduces it as an indicative biomarker of AKI based on provided literature and our presented
results.