Diagnostic Utility of Plasma Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for Early Detection of Acute Kidney Injury in Severe Burn Patients

International Journal of Medicine and Medical Sciences | Vol. 13, No. 2, February 2023 | pp. 9–16

DOI: 10.46882/2023/IJMMS/130009

Original Research Article

Diagnostic Utility of Plasma Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for Early Detection of Acute Kidney Injury in Severe Burn Patients

Charles O. Igwe¹, Rachel L. Sanon², Anthony D. Boateng¹*

¹Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria.

²Department of Nephrology, Faculty of Health Sciences, Université de Ouagadougou, Ouagadougou, Burkina Faso.

Abstract:

Acute kidney injury (AKI) significantly increases morbidity and mortality in severe burn patients, but traditional serum creatinine variations are slow. This prospective diagnostic study evaluated the accuracy of plasma neutrophil gelatinase-associated lipocalin (pNGAL) for early AKI detection following major thermal injury. We evaluated 120 adult patients with burns exceeding 20% of their total body surface area. Plasma NGAL was quantified at admission, 6, 12, and 24 hours post-injury, while serum creatinine was monitored daily for 7 days. AKI was defined using the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Thirty-six patients developed confirmed AKI (30.0%) within 48 hours. In the AKI cohort, pNGAL concentrations rose significantly from a baseline of 92.4 ± 14.8 ng/mL to 215.8 ± 32.4 ng/mL at 6 hours post-burn (p < 0.01), long before serum creatinine showed changes. Receiver Operating Characteristic (ROC) analysis showed that 6-hour pNGAL at a cutoff value of 150 ng/mL had a sensitivity of 91.7%, a specificity of 85.7%, and an Area Under the Curve (AUC) of 0.91 (95% CI = 0.84–0.96). In comparison, 24-hour serum creatinine achieved an AUC of only 0.65. Plasma NGAL serves as a highly sensitive and precise early diagnostic biomarker for thermal-injury-induced acute renal damage, allowing for early optimization of fluid resuscitation and renal preservation protocols.

Keywords: Acute Kidney Injury, Severe Burns, Neutrophil Gelatinase-Associated Lipocalin, Biomarkers, Thermal Injury, Renal Function

Manuscript Timeline: Received: November 12, 2022; Revised: December 20, 2022; Accepted: January 15, 2023; Published: February 15, 2023.

Citation: Igwe CO, Sanon RL, Boateng AD. Diagnostic Utility of Plasma Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for Early Detection of Acute Kidney Injury in Severe Burn Patients. International Journal of Medicine and Medical Sciences, 2023, 13(2): 9–16. DOI: 10.46882/2023/IJMMS/130009

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