Background: Neutrophil gelatinase associated lipocalin (NGAL) is a biomarker of kidney injury. We examined\r\nplasma levels of NGAL in a cohort of 57 kidney allograft recipients (Tx group, 39 �± 13 years), a uraemic group of\r\n40 patients remaining on the waiting list (47 �± 11 years) and a control group of 14 healthy subjects matched for\r\nage, sex and body mass index (BMI). The kidney graft recipients were studied at baseline before transplantation\r\nand 3 and 12 months after transplantation and the uraemic group at baseline and after 12 months.\r\nMethods: NGAL was measured using a validated in-house Time-Resolved Immuno-flourometric assay (TRIFMA).\r\nRepeated measurements differed by < 10% and mean values were used for statistical analyses. Spearman rank\r\norder correlation analysis and the Kruskal-Wallis non-parametric test were used to evaluate the association of NGAL\r\nconcentrations with clinical parameters.\r\nResults: Plasma NGAL levels before transplantation in the Tx and uraemic groups were significantly higher than in\r\nthe healthy controls (1,251 �µg/L, 1,478 �µg/L vs. 163 �µg/L, p < 0.0001). In the Tx group NGAL concentrations were\r\nassociated with serum creatinine (R = 0.51, p < 0.0001), duration of end-stage renal failure (R = 0.41, p = 0.002) and\r\nleukocyte count (R = 0.29, p < 0.026). At 3 and 12 months plasma NGAL concentrations declined to 223 �µg/L and\r\n243 �µg/L, respectively and were associated with homocysteine (R = 0.39, p = 0.0051 and R = 0.47, p = 0.0007).\r\nConclusions: Plasma NGAL is a novel marker of kidney function, which correlates to duration of end-stage renal\r\nfailure (ESRD) and serum creatinine in uraemic patients awaiting kidney transplantation. Plasma NGAL is associated\r\nwith homocysteine in transplanted patients. The prognostic value of these findings requires further studies.
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