Evaluation of “Neutrophil gelatinase-associated lipocalin” as an early biomarker of kidney damage in diabetic patients
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Introduction: NGAL is an early biomarker to detect tubular kidney damage and early renal failure in patients with type 2 diabetes mellitus since its serum concentration rises 2h after the damage and precedes the increase in serum creatinine concentration by 24 hours, surpassing traditional biomarkers such as creatinine, microalbuminuria, albuminuria, cystatin C and KIM-1. in sensitivity (90 - 95%) and specificity (90 - 95%). Objectives: To analyze whether the combination of NGAL and other biomarkers (such as KIM-1, microalbuminuria, cystatin C, etc.) improves diagnostic accuracy for the detection of tubular damage in patients with glomerular disease. Methodology: A documentary literature review is conducted, with a descriptive, non-experimental, and analytical approach using inclusion and exclusion criteria to apply it to the PRISMA methodology. Results: NGAL is a highly sensitive (90-95%) and specific (90-95%) biomarker to detect renal failure in early stages even before traditional biomarkers since it rises between 2 and 6 hours after kidney damage, very useful in patients who have type II diabetes mellitus due to their tendency to develop diabetic nephropathy and although its cost is higher, its predictive and preventive value justifies it and can be measured in different samples such as urine, serum, plasma and even cerebrospinal fluid. Studies show that elevated levels of NGAL in urine and serum are associated with an increased risk of progression of chronic kidney disease, inhibiting this protein could be risky as it also has protective functions in initial stages of kidney damage. NGAL is an early and reliable biomarker with high sensitivity and specificity, being able to detect kidney damage even earlier than traditional biomarkers and useful in urgent situations. The combined use of NGAL with other markers such as KIM-1, microalbuminuria and cystatin C improves the detection of kidney damage, especially in glomerular disease, however, NGAL stands out in the evaluation of tubular damage. General study area: Clinical Laboratory. Specific area of study: Uroanalysis. Type of article: Systematic bibliographic review.
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