A prospective cohort study has shown plasma neutrophil gelatinase-associated lipocalin (NGAL) to be an accurate biomarker for predicting acute kidney injury (AKI) in patients admitted from the emergency department (ED).

As Prasad Devarajan, MD, and colleagues described in the Clinical Journal of the American Society of Nephrology, 21% of 616 persons admitted to a hospital from the ED were classified as AKI.

Compared with other patients, this group had the highest median levels of plasma NGAL (146 to 174 ng/mL at various time points), which increased with AKI severity (207 to 244 ng/mL).

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The discriminative ability of plasma NGAL improved with higher grades of severity. The test distinguished AKI from normal function and transient azotemia, and could classify patients into low-, moderate-, and high-risk AKI. Use of plasma NGAL resulted in a net reclassification improvement of 94.3%.