Early detection of acute kidney injury in critically ill burn patients: Evaluating the predictive role of serum and urinary NGAL

Background: Early detection of acute kidney injury (AKI) in critically ill burn patients is crucial for improving outcomes. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a promising biomarker for early AKI detection. This study aimed to evaluate the efficacy of serum and urinary NGAL levels in predicting AKI in burn patients admitted to the intensive care unit (ICU).Methods: A prospective observational study was conducted on 31 burn patients admitted to the burn ICU. Serum and urinary NGAL levels were measured at admission (0 hours) and at 12, 24, 36, 48, and 72 hours post-admission. AKI was defined using the RIFLE and AKIN criteria. Renal replacement therapy (RRT) requirements, mortality, and other clinical parameters were recorded. Statistical analyses were performed to assess the correlation between NGAL levels and AKI development.Results: Of the 31 patients, 48.4% required RRT, and 45.2% died. Serum NGAL levels at 0 and 12 hours were significantly higher in patients who developed AKI (p<0.05). A serum NGAL cutoff of 251 ng/ml was identified as a significant predictor of AKI (p<0.05). Urinary NGAL levels did not show significant predictive value for AKI. Mortality was significantly associated with higher burn surface area, increased fluid requirements, and higher SOFA and APACHE II scores (p<0.01).Conclusion: Serum NGAL levels are elevated early in burn patients who develop AKI, suggesting its potential as a predictive biomarker. Urinary NGAL did not show significant predictive value. Further studies with larger cohorts are needed to validate these findings and explore the role of NGAL in guiding early interventions in burn patients.