Triage NGAL Test allows early identification of AKI in ICU patients

Oct 6 2009

According to a new study now available online, and to be published in an upcoming issue of the Journal of Critical Care, bedside testing for a blood biomarker called neutrophil gelatinase-associated lipocalin (NGAL) in patients being admitted to the intensive care unit can help to identify patients at risk for acute kidney injury (AKI). The study tested blood samples collected during the first 2 hours of ICU admission using the Triage® NGAL Test, a product currently sold by Inverness Medical Innovations, Inc. (NYSE: IMA) outside of the United States.

Many patients admitted to the ICU will suffer from acute kidney injury, some of whom will ultimately lose kidney function entirely and develop the need for renal replacement therapy (dialysis). When this occurs mortality rates are extremely high. Today, by the time that AKI has been detected by standard clinical measures, a substantial portion of renal function may already have been lost and interventions may not have much effect on the patient's outcome.

However the study suggests that a rapid test for NGAL could allow clinicians to rapidly assess if a critically ill patient is suffering from AKI perhaps in time to make meaningful interventions.

In this study, researchers at the University Hospital of Clermont-Ferrand, France, found that critically ill patients being admitted to the ICU with an elevated blood NGAL level were very likely to suffer from AKI. Using a cut-off level of 150ng/mL for blood NGAL, the sensitivity and specificity to predict AKI were 82% and 97%, respectively.

Measuring blood NGAL with a simple beside test allows for immediate results and early identification of AKI which was only realized by traditional clinical markers of AKI 48 hours after the NGAL increase, according to this study.

"A bedside blood test like this could be tremendously important for critically ill patients. So far therapeutic interventions for patients with AKI have been relatively unsuccessful. This is likely because they are applied late once kidney function is already lost. Knowing which patients are in trouble in advance may allow clinicians to choose therapies that will minimize further harm to the kidneys and may allow for the study of new therapeutic interventions. If further studies confirm our hypothesis, this bedside blood test could become the corner stone of a new therapeutic age," said Dr. Jean-Michel Constantin of the University Hospital of Clermont-Ferrand.

Considering the US, EU and Australia/New Zealand alone, Inverness estimates that in 2008 approximately 2.4 million patients at high risk of AKI were admitted to ICUs. Subject to confirmation through future trials, Inverness also expects the Triage NGAL Test to offer similar diagnostic benefits in hospital emergency rooms.