<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03034876</url>
  </required_header>
  <id_info>
    <org_study_id>4399-Ped-16</org_study_id>
    <nct_id>NCT03034876</nct_id>
  </id_info>
  <brief_title>Utility of NGAL to Diagnose AKI in Critically Ill Children</brief_title>
  <official_title>Acute Kidney Injury Based on Neutrophil Gelatinase-Associated Lipocalcin (NGAL) in a Pediatric Intensive Care Unit of Tertiary Care Hospital Karachi, Pakistan</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Aga Khan University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Aga Khan University</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      Acute Kidney Injury is common in critically ill children and is associated with high&#xD;
      morbidity and mortality in pediatric intensive care unit. The serum creatinine is still a&#xD;
      gold standard test for diagnosis of AKI, but it rises after 1 to 3 days of injury . However,&#xD;
      Neutrophil Gelatinase-Associated Lipocalcin (NGAL) is an emerging biomarker in identifying&#xD;
      AKI at an early stages, which may in future help us in promptly instituting reno-protective&#xD;
      interventions like avoidance of nephrotoxic exposure and contrast agents, maintenance of&#xD;
      euvolemia and perfusion pressure which will not only preventing kidney from further failing,&#xD;
      decrease the use of very expensive and complicated renal supportive therapy like continuous&#xD;
      renal replacement therapy (CRRT) as well as in decreasing morbidity and mortality related to&#xD;
      AKI.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Introduction:&#xD;
&#xD;
      Acute kidney injury (AKI) is complex disorder affecting the millions of children around the&#xD;
      world where approximately 46% of critically ill individual developed acute kidney injury&#xD;
      every year (1, 2). An annual incidence of 3.3 cases/100,000 children along with hospital&#xD;
      mortality rate of up to 25-50% have reported from developed countries (3) This is even high&#xD;
      for developing countries, where annual incidence is 30-50% (4, 5). Furthermore, acute kidney&#xD;
      injury leads to significant healthcare use, with cost estimated between 8 billion dollars&#xD;
      (4). An early diagnosis is the key to prevent morbidity and mortality related to AKI.&#xD;
&#xD;
      The diagnosis of AKI depends upon elevated serum creatinine level or decrease in urine output&#xD;
      . Early detection of AKI is essential. The currently use creatinine clearance (CrCl) is&#xD;
      calculated through Schwartz formula. The level of serum creatinine is poor marker for early&#xD;
      diagnosis. Because it varies with age, gender, hydration and muscle mass and metabolism.&#xD;
      Creatinine never rise until &gt;50% of renal function lost, amount of tubular secretion&#xD;
      overestimate at lower GFR, and in acute changes in GFR. During acute changes of GFR in AKI,&#xD;
      serum creatinine doesn't accurately depict kidney function until steady state equilibrium has&#xD;
      been achieved, which may require several days. There are some biomarker, with high&#xD;
      sensitivity and specificity, which can be used as a tool for early detection of AKI, and&#xD;
      prevent the burden of mortality and morbidity in intensive care unit (6, 7). Neutrophil&#xD;
      gelatinase-associated Lipocalcin (NGAL) recently identified as one of robust marker in AKI&#xD;
      (8). Several published reports that plasma NGA is raised in acute kidney injury before rise&#xD;
      in serum creatinine (9). A Study conducted by Mishra et al, in US showed that the 2 hours&#xD;
      sensitivity is 70% and specificity 94% for NGAL to predict AKI (10). A developed country data&#xD;
      showed 84% and 79% sensitivity , and 96% and 90% specificity of NGAL to predict the AKI (2,&#xD;
      11) , (see Annexure 1) . However, there is scarce of information available as plasma NGAL is&#xD;
      an early diagnostic marker from Pakistan.&#xD;
&#xD;
      Rationale:&#xD;
&#xD;
      We know that serum creatinine is a gold standard for diagnosis of AKI it is cheaper test to&#xD;
      diagnose , but it rises after 1 to 3 days of injury . However, NGAL is a relatively costly&#xD;
      test but an emerging biomarker in identifying AKI at an early stages, which may in future&#xD;
      help us in promptly instituting reno-protective interventions like avoidance of nephrotoxic&#xD;
      exposure and contrast agents, maintenance of euvolemia and perfusion pressure which will not&#xD;
      only preventing kidney from further failing, decrease the use of very expensive and&#xD;
      complicated renal supportive therapy like continuous renal replacement therapy (CRRT) as well&#xD;
      as in decreasing morbidity and mortality related to AKI.&#xD;
&#xD;
      Objective:&#xD;
&#xD;
      To determine the diagnostic accuracy of serum neutrophil gelatinase-associated Lipocalcin&#xD;
      (NGAL) , in detection of acute kidney injury by comparing creatinine clearance which is gold&#xD;
      standard , in pediatric intensive care unit of Aga khan university hospital Karachi .&#xD;
&#xD;
      Methods:&#xD;
&#xD;
      We will be conducting a prospective observational study in a closed&#xD;
      multidisciplinary-cardiothoracic Pediatric Intensive Care Unit (PICU) of Aga Khan University&#xD;
      Hospital after approval of Ethical Review Committee.&#xD;
&#xD;
      Operational Definition:&#xD;
&#xD;
      Acute Kidney Injury (AKI): AKI is diagnosed according to pediatric RIFLE criteria. Pediatric&#xD;
      RIFLE criteria stratifies AKI when eCrCl decreased by 25 % in first 48hours of PICU.&#xD;
&#xD;
      Shock: Shock is defined by use of vasoactive-inotropic support for at least more than 12&#xD;
      hours to maintain hemodynamics of acutely ill children in PICU for this study.&#xD;
&#xD;
      Neutrophil gelatinase-associated Lipocalcin (NGAL): NGAL is biomarker is measured&#xD;
      quantitatively by a rapid , non - competitive Fluorescence Immunoassay (12) . Level of more&#xD;
      than 150 mg/dl will be considered as a positive for diagnosis of AKI.&#xD;
&#xD;
      Sample Size Calculation:&#xD;
&#xD;
      If prevalence of AKI in children with shock is 46%, the sensitivity and specificity of plasma&#xD;
      NGAL is 0.9 and 0.79 respectively and margin of error is 0.1%, the sample size will be 140&#xD;
      participants.&#xD;
&#xD;
      Participants:&#xD;
&#xD;
        -  Inclusion Criteria: All children with either gender aged of 1 month - 16 years who&#xD;
           required vasoactive-inotropic drugs on admission and stayed for more than 48 hours in&#xD;
           PICU of tertiary care unit of Aga Khan University Hospital, Karachi.&#xD;
&#xD;
        -  Exclusion Criteria: All those children who with chronic kidney disease or previous&#xD;
           history of renal injury will be excluded&#xD;
&#xD;
      Study Protocol:&#xD;
&#xD;
      The participants who fulfill inclusion and exclusion criteria of the study will be enrolled&#xD;
      by daily surveillance of PICU. The informed consent will be obtained from parents or legal&#xD;
      guardian. The amount of blood about 1/3rd tea spoon ( 1.5ml ) will be collected from already&#xD;
      existing central line without any extra prick of participants at three different time&#xD;
      interval of 0 , 12 and 48 hours for plasma-NGAL and serum creatinine test in PICU. Then&#xD;
      samples will be sent to main laboratory of our hospital . Blood tests ( NGAL and Serum&#xD;
      Creatinine ) expenses will be paid from approved grant of University Research Council . Serum&#xD;
      NGAL is measured quantitatively by a rapid , non - competitive Fluorescence Immunoassay (12)&#xD;
      . The Triage® NGAL test is a point - of - care , fluorescence - based immunoassay used in&#xD;
      conjunction with the Triage Meter (Biosite Inc . ) for the rapid quantitative measurement of&#xD;
      NGAL concentration. The serum creatinine will be measured by Jafe's method on ADVIA 1800&#xD;
      Chemistry System (Siemens Healthliners, Germany) , and then creatinine clearance will be&#xD;
      calculated by modified Schwartz formula . (19)&#xD;
&#xD;
      Data Collection:&#xD;
&#xD;
      Data variables will be collected on a structured case report form which included demographic&#xD;
      variables (age, gender, weight, height), clinical and laboratory variables like admission&#xD;
      diagnosis, comorbidities, severity illness score (PRISM III score), use of vasoactive drugs,&#xD;
      mechanical ventilation, urine output, fluid balance, serum creatinine and plasma NGAL. The&#xD;
      discharge status as alive vs. expired, length of mechanical ventilation and hospitalization&#xD;
      and use of renal supportive therapy like peritoneal dialysis will also recorded on case&#xD;
      report form.&#xD;
&#xD;
      Outcome:&#xD;
&#xD;
      The primary outcome of this study is to evaluate the level of plasma NGAL in children who is&#xD;
      in shock with and without AKI according to RIFLE criteria.&#xD;
&#xD;
      Statistical Analysis:&#xD;
&#xD;
      Data will be entered and analyzed into SPSS V20 (SPSS Inc. Chicago, IL).Normally distributed&#xD;
      continuous variables will be reported as mean with standard deviation (SD) and will be&#xD;
      compared with student's test. Non-normally continuous distributed data will be reported as&#xD;
      medians with interquartile range (IQR) and will be compared with Man Whitney test and Kruskal&#xD;
      Wallis test. The categorical data will be reported as proportion and will be compared as&#xD;
      Fischer's exact test or Chi-square test. The association between variables will be assessed&#xD;
      by Spearman rank order correlation analysis. The diagnostic accuracy of plasma NGAL to&#xD;
      predict AKI in children with shock will be defined by calculation of Area Under Curve (AUC)&#xD;
      of Receiving Operating Characteristics (ROC) Curves. An AUC of 0.5 is no better than by&#xD;
      chance, whereas a value of 1.0 indicates a perfect biomarker. A p-value of &lt;0.05 was&#xD;
      considered as statistically significant.&#xD;
&#xD;
      Ethical Consideration:&#xD;
&#xD;
      All data variables will be stored in a password protected computer and strict confidentiality&#xD;
      will be maintained.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date type="Anticipated">March 1, 2017</start_date>
  <completion_date type="Anticipated">December 2017</completion_date>
  <primary_completion_date type="Anticipated">December 2017</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Incidence of Acute Kidney Injury</measure>
    <time_frame>within 24 hour</time_frame>
    <description>serum will sent to plasma any time of day and test will run once a day</description>
  </primary_outcome>
  <enrollment type="Anticipated">140</enrollment>
  <condition>Acute Kidney Injury in Critically Ill Children</condition>
  <biospec_retention>Samples Without DNA</biospec_retention>
  <biospec_descr>
    <textblock>
      Plasma of participants will be analyzed for creatinine and Neutrophil Gelatinase-Associated&#xD;
      Lipocalcin (NGAL&#xD;
    </textblock>
  </biospec_descr>
  <eligibility>
    <study_pop>
      <textblock>
        All critically ill children admitted in pediatric intensive care unit and receiving&#xD;
        inotrope&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        All critically ill children who is recieving inotrope in pediatric intensive care unit -&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Pre-existing kidney disease&#xD;
&#xD;
          -  Chronic kidney disease&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>1 Month</minimum_age>
    <maximum_age>16 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <reference>
    <citation>Rustagi RS, Arora K, Das RR, Pooni PA, Singh D. Incidence, risk factors and outcome of acute kidney injury in critically ill children - a developing country perspective. Paediatr Int Child Health. 2017 Feb;37(1):35-41. doi: 10.1080/20469047.2015.1120409. Epub 2016 Jan 9.</citation>
    <PMID>26752169</PMID>
  </reference>
  <reference>
    <citation>Naik S, Sharma J, Yengkom R, Kalrao V, Mulay A. Acute kidney injury in critically ill children: Risk factors and outcomes. Indian J Crit Care Med. 2014 Mar;18(3):129-33. doi: 10.4103/0972-5229.128701.</citation>
    <PMID>24701061</PMID>
  </reference>
  <reference>
    <citation>Waikar SS, Bonventre JV. Biomarkers for the diagnosis of acute kidney injury. Nephron Clin Pract. 2008;109(4):c192-7. doi: 10.1159/000142928. Epub 2008 Sep 18.</citation>
    <PMID>18802367</PMID>
  </reference>
  <reference>
    <citation>Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A; NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009 Dec;54(6):1012-24. doi: 10.1053/j.ajkd.2009.07.020. Epub 2009 Oct 21.</citation>
    <PMID>19850388</PMID>
  </reference>
  <reference>
    <citation>Doi K, Negishi K, Ishizu T, Katagiri D, Fujita T, Matsubara T, Yahagi N, Sugaya T, Noiri E. Evaluation of new acute kidney injury biomarkers in a mixed intensive care unit. Crit Care Med. 2011 Nov;39(11):2464-9. doi: 10.1097/CCM.0b013e318225761a.</citation>
    <PMID>21705884</PMID>
  </reference>
  <verification_date>January 2017</verification_date>
  <study_first_submitted>January 25, 2017</study_first_submitted>
  <study_first_submitted_qc>January 25, 2017</study_first_submitted_qc>
  <study_first_posted type="Estimate">January 27, 2017</study_first_posted>
  <last_update_submitted>January 25, 2017</last_update_submitted>
  <last_update_submitted_qc>January 25, 2017</last_update_submitted_qc>
  <last_update_posted type="Estimate">January 27, 2017</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Aga Khan University</investigator_affiliation>
    <investigator_full_name>Anwar ul Haq</investigator_full_name>
    <investigator_title>Associate Professor</investigator_title>
  </responsible_party>
  <keyword>&quot;Acute Kidney Injury&quot;, diagnosis, children, shock</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Acute Kidney Injury</mesh_term>
    <mesh_term>Critical Illness</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03034876
org study id: 4399-Ped-16
nct id: NCT03034876
lead sponsor: 
has dmc: No
Acute Kidney Injury is common in critically ill children and is associated with high
      morbidity and mortality in pediatric intensive care unit. The serum creatinine is still a
      gold standard test for diagnosis of AKI, but it rises after 1 to 3 days of injury . However,
      Neutrophil Gelatinase-Associated Lipocalcin (NGAL) is an emerging biomarker in identifying
      AKI at an early stages, which may in future help us in promptly instituting reno-protective
      interventions like avoidance of nephrotoxic exposure and contrast agents, maintenance of
      euvolemia and perfusion pressure which will not only preventing kidney from further failing,
      decrease the use of very expensive and complicated renal supportive therapy like continuous
      renal replacement therapy (CRRT) as well as in decreasing morbidity and mortality related to
      AKI.
Introduction:

      Acute kidney injury (AKI) is complex disorder affecting the millions of children around the
      world where approximately 46% of critically ill individual developed acute kidney injury
      every year (1, 2). An annual incidence of 3.3 cases/100,000 children along with hospital
      mortality rate of up to 25-50% have reported from developed countries (3) This is even high
      for developing countries, where annual incidence is 30-50% (4, 5). Furthermore, acute kidney
      injury leads to significant healthcare use, with cost estimated between 8 billion dollars
      (4). An early diagnosis is the key to prevent morbidity and mortality related to AKI.

      The diagnosis of AKI depends upon elevated serum creatinine level or decrease in urine output
      . Early detection of AKI is essential. The currently use creatinine clearance (CrCl) is
      calculated through Schwartz formula. The level of serum creatinine is poor marker for early
      diagnosis. Because it varies with age, gender, hydration and muscle mass and metabolism.
      Creatinine never rise until >50% of renal function lost, amount of tubular secretion
      overestimate at lower GFR, and in acute changes in GFR. During acute changes of GFR in AKI,
      serum creatinine doesn't accurately depict kidney function until steady state equilibrium has
      been achieved, which may require several days. There are some biomarker, with high
      sensitivity and specificity, which can be used as a tool for early detection of AKI, and
      prevent the burden of mortality and morbidity in intensive care unit (6, 7). Neutrophil
      gelatinase-associated Lipocalcin (NGAL) recently identified as one of robust marker in AKI
      (8). Several published reports that plasma NGA is raised in acute kidney injury before rise
      in serum creatinine (9). A Study conducted by Mishra et al, in US showed that the 2 hours
      sensitivity is 70% and specificity 94% for NGAL to predict AKI (10). A developed country data
      showed 84% and 79% sensitivity , and 96% and 90% specificity of NGAL to predict the AKI (2,
      11) , (see Annexure 1) . However, there is scarce of information available as plasma NGAL is
      an early diagnostic marker from Pakistan.

      Rationale:

      We know that serum creatinine is a gold standard for diagnosis of AKI it is cheaper test to
      diagnose , but it rises after 1 to 3 days of injury . However, NGAL is a relatively costly
      test but an emerging biomarker in identifying AKI at an early stages, which may in future
      help us in promptly instituting reno-protective interventions like avoidance of nephrotoxic
      exposure and contrast agents, maintenance of euvolemia and perfusion pressure which will not
      only preventing kidney from further failing, decrease the use of very expensive and
      complicated renal supportive therapy like continuous renal replacement therapy (CRRT) as well
      as in decreasing morbidity and mortality related to AKI.

      Objective:

      To determine the diagnostic accuracy of serum neutrophil gelatinase-associated Lipocalcin
      (NGAL) , in detection of acute kidney injury by comparing creatinine clearance which is gold
      standard , in pediatric intensive care unit of Aga khan university hospital Karachi .

      Methods:

      We will be conducting a prospective observational study in a closed
      multidisciplinary-cardiothoracic Pediatric Intensive Care Unit (PICU) of Aga Khan University
      Hospital after approval of Ethical Review Committee.

      Operational Definition:

      Acute Kidney Injury (AKI): AKI is diagnosed according to pediatric RIFLE criteria. Pediatric
      RIFLE criteria stratifies AKI when eCrCl decreased by 25 % in first 48hours of PICU.

      Shock: Shock is defined by use of vasoactive-inotropic support for at least more than 12
      hours to maintain hemodynamics of acutely ill children in PICU for this study.

      Neutrophil gelatinase-associated Lipocalcin (NGAL): NGAL is biomarker is measured
      quantitatively by a rapid , non - competitive Fluorescence Immunoassay (12) . Level of more
      than 150 mg/dl will be considered as a positive for diagnosis of AKI.

      Sample Size Calculation:

      If prevalence of AKI in children with shock is 46%, the sensitivity and specificity of plasma
      NGAL is 0.9 and 0.79 respectively and margin of error is 0.1%, the sample size will be 140
      participants.

      Participants:

        -  Inclusion Criteria: All children with either gender aged of 1 month - 16 years who
           required vasoactive-inotropic drugs on admission and stayed for more than 48 hours in
           PICU of tertiary care unit of Aga Khan University Hospital, Karachi.

        -  Exclusion Criteria: All those children who with chronic kidney disease or previous
           history of renal injury will be excluded

      Study Protocol:

      The participants who fulfill inclusion and exclusion criteria of the study will be enrolled
      by daily surveillance of PICU. The informed consent will be obtained from parents or legal
      guardian. The amount of blood about 1/3rd tea spoon ( 1.5ml ) will be collected from already
      existing central line without any extra prick of participants at three different time
      interval of 0 , 12 and 48 hours for plasma-NGAL and serum creatinine test in PICU. Then
      samples will be sent to main laboratory of our hospital . Blood tests ( NGAL and Serum
      Creatinine ) expenses will be paid from approved grant of University Research Council . Serum
      NGAL is measured quantitatively by a rapid , non - competitive Fluorescence Immunoassay (12)
      . The Triage® NGAL test is a point - of - care , fluorescence - based immunoassay used in
      conjunction with the Triage Meter (Biosite Inc . ) for the rapid quantitative measurement of
      NGAL concentration. The serum creatinine will be measured by Jafe's method on ADVIA 1800
      Chemistry System (Siemens Healthliners, Germany) , and then creatinine clearance will be
      calculated by modified Schwartz formula . (19)

      Data Collection:

      Data variables will be collected on a structured case report form which included demographic
      variables (age, gender, weight, height), clinical and laboratory variables like admission
      diagnosis, comorbidities, severity illness score (PRISM III score), use of vasoactive drugs,
      mechanical ventilation, urine output, fluid balance, serum creatinine and plasma NGAL. The
      discharge status as alive vs. expired, length of mechanical ventilation and hospitalization
      and use of renal supportive therapy like peritoneal dialysis will also recorded on case
      report form.

      Outcome:

      The primary outcome of this study is to evaluate the level of plasma NGAL in children who is
      in shock with and without AKI according to RIFLE criteria.

      Statistical Analysis:

      Data will be entered and analyzed into SPSS V20 (SPSS Inc. Chicago, IL).Normally distributed
      continuous variables will be reported as mean with standard deviation (SD) and will be
      compared with student's test. Non-normally continuous distributed data will be reported as
      medians with interquartile range (IQR) and will be compared with Man Whitney test and Kruskal
      Wallis test. The categorical data will be reported as proportion and will be compared as
      Fischer's exact test or Chi-square test. The association between variables will be assessed
      by Spearman rank order correlation analysis. The diagnostic accuracy of plasma NGAL to
      predict AKI in children with shock will be defined by calculation of Area Under Curve (AUC)
      of Receiving Operating Characteristics (ROC) Curves. An AUC of 0.5 is no better than by
      chance, whereas a value of 1.0 indicates a perfect biomarker. A p-value of <0.05 was
      considered as statistically significant.

      Ethical Consideration:

      All data variables will be stored in a password protected computer and strict confidentiality
      will be maintained.
observational model: Cohort
time perspective: Prospective
measure: Incidence of Acute Kidney Injury
time frame: within 24 hour
description: serum will sent to plasma any time of day and test will run once a day
Plasma of participants will be analyzed for creatinine and Neutrophil Gelatinase-Associated
      Lipocalcin (NGAL
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 1 Month
maximum age: 16 Years
healthy volunteers: No
citation: Rustagi RS, Arora K, Das RR, Pooni PA, Singh D. Incidence, risk factors and outcome of acute kidney injury in critically ill children - a developing country perspective. Paediatr Int Child Health. 2017 Feb;37(1):35-41. doi: 10.1080/20469047.2015.1120409. Epub 2016 Jan 9.
PMID: 26752169
citation: Naik S, Sharma J, Yengkom R, Kalrao V, Mulay A. Acute kidney injury in critically ill children: Risk factors and outcomes. Indian J Crit Care Med. 2014 Mar;18(3):129-33. doi: 10.4103/0972-5229.128701.
PMID: 24701061
citation: Waikar SS, Bonventre JV. Biomarkers for the diagnosis of acute kidney injury. Nephron Clin Pract. 2008;109(4):c192-7. doi: 10.1159/000142928. Epub 2008 Sep 18.
PMID: 18802367
citation: Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A; NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009 Dec;54(6):1012-24. doi: 10.1053/j.ajkd.2009.07.020. Epub 2009 Oct 21.
PMID: 19850388
citation: Doi K, Negishi K, Ishizu T, Katagiri D, Fujita T, Matsubara T, Yahagi N, Sugaya T, Noiri E. Evaluation of new acute kidney injury biomarkers in a mixed intensive care unit. Crit Care Med. 2011 Nov;39(11):2464-9. doi: 10.1097/CCM.0b013e318225761a.
PMID: 21705884
responsible party type: Principal Investigator
investigator affiliation: Aga Khan University
investigator full name: Anwar ul Haq
investigator title: Associate Professor
mesh term: Acute Kidney Injury
mesh term: Critical Illness
sharing ipd: No