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Evaluation of serum and urine neutrophil gelatinase-associated lipocalin and cystatin C as biomarkers of acute kidney injury in horses

Natalia Siwińska
Natalia Siwińska
, 
Agnieszka Żak
Agnieszka Żak
 e 
Urszula Pasławska
Urszula Pasławska
   | 16 mag 2021
Journal of Veterinary Research's Cover Image
INFORMAZIONI SU QUESTO ARTICOLO
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Pubblicato online: 16 mag 2021
Pagine: 245 - 252
Ricevuto: 19 nov 2020
Accettato: 22 apr 2021
DOI: https://doi.org/10.2478/jvetres-2021-0025
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© 2021 N. Siwińska et al. published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1

Results of serum (S) and urinary (U) neutrophil gelatinase-associated lipocalin (NGAL) in healthy horses (non-acute kidney injury (AKI) group), horses at risk of acute kidney injury (AKI-risk group; divided into colic sufferers, recipients of nonsteroidal anti-inflammatory drugs (NSAIDs) and recipients of gentamicin) and horses diagnosed with acute kidney injury (AKI group)
Results of serum (S) and urinary (U) neutrophil gelatinase-associated lipocalin (NGAL) in healthy horses (non-acute kidney injury (AKI) group), horses at risk of acute kidney injury (AKI-risk group; divided into colic sufferers, recipients of nonsteroidal anti-inflammatory drugs (NSAIDs) and recipients of gentamicin) and horses diagnosed with acute kidney injury (AKI group)

Fig. 2

Results of serum (S) and urinary (U) cystatin C in healthy horses (non-acute kidney injury (AKI) group), horses at risk of acute kidney injury (AKI-risk group; divided into colic sufferers, recipients of nonsteroidal anti-inflammatory drugs (NSAIDs) and recipients of gentamicin) and horses diagnosed with acute kidney injury (AKI group)
Results of serum (S) and urinary (U) cystatin C in healthy horses (non-acute kidney injury (AKI) group), horses at risk of acute kidney injury (AKI-risk group; divided into colic sufferers, recipients of nonsteroidal anti-inflammatory drugs (NSAIDs) and recipients of gentamicin) and horses diagnosed with acute kidney injury (AKI group)

Fig. 3

Receiver operating characteristic (ROC) analysis curve showing the sensitivity and specificity of (A) serum and (B) urinary neutrophil gelatinase-associated lipocalin (NGAL) in relation to the detection of acute kidney dysfunction in the examined horses AUC – area under ROC
Receiver operating characteristic (ROC) analysis curve showing the sensitivity and specificity of (A) serum and (B) urinary neutrophil gelatinase-associated lipocalin (NGAL) in relation to the detection of acute kidney dysfunction in the examined horses AUC – area under ROC

Fig. 4

Receiver operating characteristic (ROC) analysis curve showing the sensitivity and specificity of (A) serum and (B) cystatin C in relation to the detection of acute kidney dysfunction in the examined horses AUC – area under ROC
Receiver operating characteristic (ROC) analysis curve showing the sensitivity and specificity of (A) serum and (B) cystatin C in relation to the detection of acute kidney dysfunction in the examined horses AUC – area under ROC

Significant differences in serum and urine biomarkers between healthy horses (non-acute kidney injury (AKI) group), horses at risk of kidney injury (AKI-risk group; divided into colic sufferers, recipients of nonsteroidal anti-inflammatory drugs (NSAIDs) and recipients of gentamicin) and horses diagnosed with acute kidney injury (AKI group)

Parameter Non-AKI vs AKI-risk colic vs AKI-risk NSAIDs vs AKI-risk gentamicin vs
AKI Non-AKI AKI Non-AKI AKI Non-AKI AKI
NGAL (ng/mL) Serum 0.0030 - - - 0.0030 - 0.0200
Urine 0.0050 0.0050 - - - - -
Cystatin C (mg/L) Serum 0.0400 - - - 0.0400 - 0.0200
Urine 0.0001 0.0400 - - 0.0400 - 0.0300

Spearman’s correlation between the analysed biomarkers and selected conventional renal dysfunction biomarkers

Parameter NGAL Cystatin C
Serum Urine Serum Urine
Serum Urea rs = 0.360 NS rs = 0.300 rs = 0.340
P = 0.002 P = 0.014 P = 0.004
Creatinine NS NS NS rs = 0.300
P = 0.013
Urine Protein NS rs = 0.360 NS rs = 0.400
P < 0.005 P < 0.001
GGT : Creatinine ratio rs = 0.300 rs = 0.390 NS rs = 0.370
P = 0.012 P < 0.001 P < 0.005
FENa NS rs = 0.33 NS NS
P = 0.005

The receiver operating characteristic (ROC) analysis of serum and urinary cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) relative to kidney dysfunction in horses

Parameter Cut-off value Sensitivity Specificity Positive predictive value Negative predictive value AUC
NGAL Serum 95.20 0.54 0.93 0.60 0.92 0.73
Urine 33.10 0.64 0.71 0.30 0.90 0.66
Cystatin C Serum 0.53 0.64 0.85 0.44 0.93 0.67
Urine 0.20 0.82 0.85 0.50 0.96 0.84

Concentration of serum and urinary cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) measured in healthy horses (non-acute kidney injury (AKI) group), horses at risk of acute kidney injury (AKI-risk group; divided into colic sufferers, recipients of nonsteroidal anti-inflammatory drugs (NSAIDs) and recipients of gentamicin) and horses diagnosed with acute kidney injury (AKI group)

AKI-risk group (n = 30)
Parameter Non-AKI group (n = 30) Colic (n = 10) NSAIDS (n = 10) Gentamicin (n = 10) All AKI group (n = 11)
Min–max Me (Q1– n’ Q3) Min–max Me (Q1– n’ Q3) Min–max Me (Q1– n’ Q3) Min–max Me (Q1– n’ Q3) Min–max Me (Q1–Q3) n’ Min–max Me (Q1–Q3) n’
NGAL Serum 25.00– 95.20 50.50 (38.80– 0 58.80) 30.70– 201.90 73.00 (54.50– 3 129.70) 27.20– 74.20 45.80 (33.70– 0 61.10) 31.10–91.20 48.30 (40.40– 0 57.30) 27.20– 201.90 51.10 (40.40– 3 66.90) 50.60– 277.60 98.10 (59.40– 6 128.20)
(ng/mL) Urine 8.50– 41.70 20.70 (17.90– 4 24.50) 12.90– 112.10 53.40 (31.10– 7 64.20) 18.80– 59.80 30.20 (23.10– 3 47.80) 12.80–60.90 29.80 (25.20– 2 33.00) 12.80– 112.10 32.30 (23.70– 12 55.80) 19.10– 223.00 36.60 (26.80– 7 89.90)
Cystatin Serum C 0.13–0.71 0.25 (0.19– 2 0.37) 0.09–1.01 0.36 (0.19– 3 0.60) 0.08–0.40 0.24 (0.15– 0 0.26) 0.06–0.55 0.19 (0.13– 1 0.26) 0.06–1.01 0.23 (0.15– 0.37) 4 0.07–1.71 0.61 (0.37– 7 1.13)
(mg/L) Urine 0.06–0.50 0.10 (0.07– 2 0.13) 0.02–0.43 0.25 (0.10– 5 0.35) 0.07–0.19 0.13 (0.12– 0 0.13) 0.05–0.34 0.14 (0.08– 1 0.19) 0.02–0.43 0.13 (0.10– 6 0.19) 0.10–0.50 0.34 (0.22– 9 0.37)
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