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

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

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7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1993-2001
Number of pages9
JournalInternational Urology and Nephrology
Volume47
Issue number12
DOIs
Publication statusPublished - Dec 1 2015
Externally publishedYes

Keywords

  • Cardiovascular disease
  • Chronic kidney disease
  • Mortality
  • NGAL
  • Prediction

ASJC Scopus subject areas

  • Nephrology
  • Urology

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    Solak, Y., Yilmaz, M. I., Siriopol, D., Saglam, M., Unal, H. U., Yaman, H., Gok, M., Cetinkaya, H., Gaipov, A., Eyileten, T., Sari, S., Yildirim, A. O., Tonbul, H. Z., Turk, S., Covic, A., & Kanbay, M. (2015). Serum neutrophil gelatinase-associated lipocalin is associated with cardiovascular events in patients with chronic kidney disease. International Urology and Nephrology, 47(12), 1993-2001. https://doi.org/10.1007/s11255-015-1136-4