The Role Of Neutrophil Gelatinase-Associated Lipocalin (NGAL) In The Evaluation Of Renal Functions In Patients With Liver Cirrhosis

Aim: Early diagnosis of renal dysfunction has clinical and prognostic importance for liver cirrhosis.The disadvantages are that creatinine and blood urea nitrogen (BUN) are dependent on age and muscle mass in demonstrating renal dysfunction. There is a need for parameters that can detect renal dysfunction early in cirrhotic patients. Our aim was to investigate the sensitivity, specificity and predictive value of serum Neutrophil Gelatinase Associated Lipocalin (NGAL), serum creatinine and BUN levels against glomerular filtration rate (GFR) in the evaluation of renal function in Child A and Child B liver cirrhosis patients. Methods: This study was conducted in a total of 84 patients with Child A or Child B liver cirrhosis who were admitted to the gastroenterology clinic between 2009 and 2010. The study was based on retrospective review of the patients' files. Clinical and laboratory parameters were recorded. Results: We found that serum NGAL 45.8%, creatinine 88.5% and BUN 84.2% positive predictive value in defining GFR for all patients in Child A and B stages. In our study, we concluded that a NGAL value of 114.17 ng/ml and above has 68.75% sensitivity and 50% specificity in indicating glomerular filtration rate. The diagnostic utility was 47.4% and it was not found significant (p= 0.053). Conclusions: It has been shown that serum creatinine values are more sensitive and specific than BUN and a new marker, NGAL, in terms of predicting the changes that may occur in the GFR of patients in Child A and B stages.