What is the role of urinary neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of acute pyelonephritis (kidney infection)?

Updated: Jul 01, 2021
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a sensitive biomarker for the diagnosis of acute pyelonephritis in children. In a case-control study of 134 children with acute pyelonephritis or febrile states of other etiology, NGAL values were significantly higher in children with acute pyelonephritis. At a cut-off value of 29.4 ng/mL, urinary NGAL had 92.5% sensitivity and 90.7% specificity for diagnosing acute pyelonephritis. NGAL was also useful for differentiating acute pyelonephritis from cystitis and differentiating cystitis from febrile states with etiology other than urinary tract infection. [14]

Urinary concentrations of NGAL may also help identify children with acute pyelonephritis who are at increased risk of developing kidney scarring. In a study of 54 children, urinary NGAL levels were significantly higher in patients with acute pyelonephritis with scarring than in those without scarring. At a cut-off value of 7.32 ng/ml, the sensitivity and specificity of this marker for diagnosing scar formation were 81.3% and 66%, respectively. [15]


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