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[Plasma NGAL and ADPKD progression].

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    Summary

    Neutrophil gelatinase-associated lipocalin (NGAL) did not prove to be a reliable biomarker for chronic kidney disease (CKD) progression in Autosomal dominant polycystic kidney disease (ADPKD) patients. Many patients had undetectable NGAL levels, questioning the assay

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    Area of Science:

    • Nephrology
    • Genetics
    • Biomarker Research

    Background:

    • Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by variable progression rates.
    • Neutrophil gelatinase-associated lipocalin (NGAL) is a proposed biomarker for chronic kidney disease (CKD) progression.
    • Inter- and intra-familial variability exists in ADPKD progression.

    Purpose of the Study:

    • To investigate whether NGAL can serve as a predictive biomarker for CKD progression in ADPKD patients.
    • To assess the correlation between baseline NGAL levels and the rate of eGFR decline in ADPKD.

    Main Methods:

    • Prospective study of 50 ADPKD patients with confirmed PKD1 or PKD2 mutations.
    • Measurement of plasma NGAL and serum creatinine (sCr) at baseline and follow-up.
    • Definition of CKD progression as a 15% decrease in estimated glomerular filtration rate (eGFR).

    Main Results:

    • NGAL levels showed an inverse correlation with baseline eGFR (r=-0.64, p<0.001).
    • A weak correlation was found between baseline NGAL and subsequent eGFR change (r=0.28, p=0.05).
    • No statistically significant relationship was observed between higher NGAL levels and ADPKD progression; 18% of patients had undetectable NGAL.

    Conclusions:

    • NGAL is not a reliable biomarker for predicting CKD progression in ADPKD patients.
    • The utility of current NGAL assays is questionable due to a significant proportion of undetectable levels in this population.