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Serum Levels of Neutrophil Gelatinase-Associated Lipocalin (NGAL) as Predictor of Acute Kidney Injury in Sickle Cell Subjects

Adedeji David Atere, Olumide Faith Ajani, David Bolaji Akinbo, Omobolaji Adewumi Adeosun and Odiaka Mark Anombem

Background: Neutrophil Gelatinase-associated Lipocalin (NGAL) has generated great interest as a novel biomarker for the timely detection of Acute Kidney Injury (AKI). This study, therefore, investigated NGAL as a predictive marker for acute kidney injury among sickle cell subjects.

Materials and methods: A total of fifty (50) sickle cell subjects aged 18-60 years and attending the sickle cell clinic of Federal Medical Centre, Owo were randomly recruited along with twenty-five (25) apparently healthy age and sexmatched non-sickle cell subjects attending the family medicine outpatient clinic of the hospital as control for the study. Plasma levels of NGAL were assessed using an Enzyme-Linked Immunosorbent Assay (ELISA) kit, while urea and creatinine were determined by standard spectrophotometric method. The results were statistically analyzed for significance at p<0.05 using one-way analysis of variance (ANOVA).

Results: NGAL and urea plasma levels were significantly (p<0.05) increased in the steady and vaso-occlusive (VOC) sickle cell subjects, glomerular filtration rate showed significant (p<0.05) reduction in both steady and VOC groups compared to the normal healthy control. The levels of urea and creatinine were increased significantly (p<0.05) in the VOC sickle cell group compared with the steady sickle cell group, whereas circulating levels of NGAL showed a significant (p<0.05) reduction in VOC sickle cell group compared with the steady sickle cell group. NGAL revealed an excellent higher area under the receiver operating curve than urea and creatinine.

Conclusion: NGAL was shown to be a sensitive tool, an early biomarker for acute kidney injury in sickle cell subjects and clinically significant for its wide availability, easy accessibility, and sensitivity in aiding early detection with a dynamic wide range for routine assessment in the management of SCD.