Neue biomarker verbessern voraussage akuten.
in short : NGAL is better and cheaper than serum creatinine
In august 2010 the german contribution to the European Cardiology Congress was placed securely in the hands of Professor Dr. Günter Breithardt; His presentation carried the stunning title: New Biomarkers improve the prediction of acute renal damage significantly in patients who suffer from heart failure (HF).
The close interaction between cardiac and renal function is becoming increasingly significant. Prof. Breithardt: “As an example, new evidence shows, that patients who had a heart attack before being admission to hospital and who an existing renal impairment, have significantly increased mortality risk. Moreover, the acute renal damage is a frequent complication in the treatment of acute Heart attacks. Approximately 20 to 40 percent of all patients who are hospitalized due to acute Heart Failure (HF) suffer an acute kidney injury in the hospital. This results in a significantly prolonged hospital stay, in rising costs of treatment and ultimately higher mortality. ”
Enter – Neutrophil gelatinase-associated lipocalin (NGAL) and neopterin
Renal biomarkers are gaining in importance because they can simplify the prediction of acute kidney injury. The Investigation Team led by Prof. Breithardt have assesed the potential benefit of bio-marker Neutrophil Gelatinase-Associated lipocalin (NGAL). The study included 87 patients with acute HF. All patients admitted complained of shortness of breath (NYHA III / IV), – they showed radiological signs of acute Heart attacks, and had a BNP value exceeding 500pg/ml. NGAL values were measured on admission and at six-hour intervals (until 48 hours after admission) , creatinine values were measured likewise up til 72 hours after admission. In total 20 percent of the patients suffered acute kidney damage during the first three days. These patients were significantly more likely to suffer from diabetes and chronic renal failure.
Still, other parameters (admission creatinine, GFR values, GFR-NGAL-entry classes or values) can predict the occurrence of renal damage. ” But – taking into account the intervals at which NGAL was measured, however, it is evident that that NGAL values increased significantly 12 hours before before creatinine levels rose” says Prof. Breithardt.”These values from the NGAL measurements were a clear indication that there was renal damage.”
