Introduction. The incidence of acute kidney injury (AKI) considerably increases the mortality rate in polytrauma victims.\nUndoubtedly, early identification of patients at risk is crucial for timely implementation of preventive strategies in order to improve\ntheir prognosis. Therefore, we aimed to investigate if serum neutrophil gelatinase-associated lipocalin (sNGAL) may serve as a\ndiagnostic biomarker of early AKI in polytrauma victims, especially considering patients needing renal replacement theory (RRT).\nMaterial and Methods. Forty consecutive polytrauma victims (ISS greaterthan or equal to 16, AISThorax greaterthan or equal to 1, age greaterthan or equal to 18 years, survival time greaterthan or equal to 48 hours),\ndirectly admitted to our level I trauma center within one posttraumatic hour, were enrolled in our prospective study. sNGAL-levels\nwere assessed at admission (initial) and on day 2 after trauma. AKI was diagnosed by an increase of serum creatinine (sCr) level\nof at least 0.3mg/dl within 48 hours. Results. Out of 30 men and 10 women (mean age, 43 years; mean ISS, 29), seven patients\ndeveloped AKI, four of them needing RRT. AKI was diagnosed in 86% of the affected individuals until day 2. Day2-sNGAL-levels\nwere higher in the AKI-group, compared to the no-AKI-group (p=0.049), and in patients treated with RRT than in individuals\nnot needing RRT (p=0.037). Noteworthy, in patients not needing RRT sNGAL-levels significantly decreased from initial to day2-\nmeasurement (p=0.040). Furthermore, at any time point during our observation period polytraumatized patients with AKI and\nday2-sNGAL-levels of at least 181.0 ng/mL presented with higher sCr-levels compared to polytraumatized patients without AKI and\nday2-sNGAL-levels lower than 181.0 ng/mL (p less than or equal to 0.029). Conclusion. Inpolytrauma victims sufferingAKI an increase in sNGAL-level\nfrom initial to day2-assessment may signalize deterioration in kidney function and thus indicate AKI progression. Unlike initial\nsNGAL-levels day2-sNGAL-levels might be an appropriate tool to define AKI and to signify the need of RRT in polytraumatized\npatients.
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