A biomarker test developed at Cincinnati Children’s to identify early acute kidney injury (AKI) in patients following surgery has now proven successful in broader clinical use.

In a study published online in the Clinical Journal of the American Society of Nephrology, the test, which measures the biomarker neutrophil gelatinase-associated lipocalin (NGAL), was used to successfully diagnose AKI in adult patients with a variety of illnesses who were admitted to hospital from the emergency department.

Prasad Devarajan, MD, Director, Division of Nephrology and Hypertension, developed the test and led the study, with collaborators at Fernando Fonseca Hospital in Portugal.

The study demonstrated that the NGAL test, which uses a single drop of blood and provides results within 15 minutes, could accurately distinguish AKI from transient reversible kidney dysfunction. Of 616 patients who participated in the study, individuals who were subsequently diagnosed with true AKI had the highest levels of neutrophil gelatinase-associated lipocalin measured at the time of hospital admission. The study also identified a cutoff point in NGAL levels above which the risk of acute kidney injury increases tenfold.

Results of a study previously published (2008) by Devarajan showed that the NGAL test predicted AKI in pediatric heart surgery patients within hours instead of days, allowing treatment that prevented serious damage to kidneys.  Prior to the NGAL test, serum creatinine was the only reliable method for detecting kidney damage; however, the long wait for results often resulted in permanent kidney damage.

With a growing number of patients coming to emergency rooms with community-acquired AKI, Devarajan says having a rapid, reliable method of detecting kidney injury is increasingly important.

“This latest study showed that this simple laboratory test provides an accurate prediction of acute kidney injury and its severity in a heterogeneous clinical setting,” says Devarajan. “The identification of biomarkers that differentiate intrinsic AKI from transient reversible forms of renal dysfunction and predict outcomes is a high priority."