Background: Hepatorenal syndrome (HRS) and spontaneous bacterial peritonitis (SBP) are a severe complication of cirrhosis which is associated with poor survival. Aim: to assess plasma neutrophil gelatinase-associated lipocalin (pNGAL) as a biomarker for the diagnosis of HRS and SBP in patients with cirrhosis. Methods: a total of 85 patients with cirrhosis (20 patients with type 1 HRS, 25 with type 2 HRS, and 25 with SBP) and 15 control subjects were included in the study. Blood samples were measured with Human NGAL sandwich ELISA. Results: Patients with type 1 , type 2 HRS and SBP had significantly higher plasma NGAL levels compared with stable cirrhosis. There was positive correlation between plasma NGAL levels and MELD-Na, ascitic fluid (r = 0.48, P < 0.001; 0.66, P < 0.001; r = 0.54, P < 0.001 respectively). ROC-curve analysis showed Plasma NAGAL at a cutoff value of 1180.5 ng/L could discriminate between patients with HRS type 1 and stable cirrhosis groups had AUROC of 1 with 95 % sensitivity, 100 % specificity, 100 % PPV and 93.8 % NPV. Conclusion: our data identify a high serum level of plasma NAGAL as a new independent predictor of the presence of HRS type 1, 2 and SBP. Significantly higher levels were detected in type 1 HRS than in type 2. |
