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

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

Journal of Veterinary Research

Volume 65 (2021): Issue 2 (June 2021)

By: Natalia Siwińska, Agnieszka Żak and Urszula Pasławska

Open Access

|May 2021

Figures & Tables

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) 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)

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) 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	r_s = 0.360	NS	r_s = 0.300	r_s = 0.340
	Urea	P = 0.002	NS	P = 0.014	P = 0.004

	Creatinine	NS	NS	NS	r_s = 0.300
	Creatinine	NS	NS	NS	P = 0.013

Urine	Protein	NS	r_s = 0.360	NS	r_s = 0.400
	Protein	NS	P < 0.005	NS	P < 0.001

	GGT : Creatinine ratio	r_s = 0.300	r_s = 0.390	NS	r_s = 0.370
	GGT : Creatinine ratio	P = 0.012	P < 0.001	NS	P < 0.005

	FENa	NS	r_s = 0.33	NS	NS
	FENa	NS	P = 0.005	NS	NS

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)

DOI: https://doi.org/10.2478/jvetres-2021-0025 | Journal eISSN: 2450-8608

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Language: English

Page range: 245 - 252

Submitted on: Nov 19, 2020

Accepted on: Apr 22, 2021

Published on: May 16, 2021

Published by: National Veterinary Research Institute in Pulawy

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

acute kidney injury,

nephrotoxicity,

Related subjects:

Molecular biology,

Microbiology and virology,

Life sciences, other,

Veterinary medicine

© 2021 Natalia Siwińska, Agnieszka Żak, Urszula Pasławska, published by National Veterinary Research Institute in Pulawy
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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