Assessing neutrophil gelatinase-associated lipocalin as an early indicator for AKI among gastroenteritis patients with dehydration

Background: Acute gastroenteritis (AGE) is a common disease observed in emergency departments (ED). Most cases of AGE are of viral causes and are self-limiting; however, in some patients, this can lead to acute kidney injury (AKI), which can lead to serious complications. Several variables have been studied to diagnose and measure the extent of morbidity due to these conditions, with neutrophil gelatinase-associated lipocalin (NGAL) being important. The present study was conducted with the aim to ascertain whether plasma NGAL levels can be used as a marker for diagnosing AKI in patients with dehydration due to AGE. Patients and Methods: A prospective cohort study was conducted among patients admitted to the ED of a tertiary healthcare centre between the years 2015 and 2017. Patients aged between 15 and 65 years who were diagnosed with AGE were included in the study. Patients with known major comorbidities or drug use were excluded from this study. The classification of dehydration was calculated in conjunction with measurements of plasma NGAL, serum creatinine (SCr), and blood urea nitrogen. Results: Of the 50 selected patients, most participants (72%) reported a SCr < 1.1 (normal). Plasma NGAL levels >100 ng/mL were observed among 44% patients, while 28% had plasma NGAL <100. There was a significant difference (p < 0.001) between the mean plasma NGAL levels in patients with mild dehydration (104.88 ± 51.38 ng/mL) when compared to those with moderate dehydration (243.83 ± 120.62 ng/mL). SCr also showed a similar trend with p < 0.002, with mean SCr of mild and moderately dehydrated groups being 0.78 ± 0.23 and 1.03 ± 0.30, respectively. Plasma NGAL and SCr levels showed a significant positive correlation (r = 0.486; p < 0.001), whereas plasma NGAL and glomerular filtration rate showed a significant negative correlation (r = −0.428; p < 0.002). Conclusion: Mild and moderately dehydrated AGE patients had significantly higher plasma NGAL concentrations, even in the early stages, with normal SCr values. Plasma NGAL levels may be used as an early biomarker to identify adults with mild or moderate dehydration who are at increased risk for developing AKI.