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European Journal of Heart Failure 2008 10(10):997-1000; doi:10.1016/j.ejheart.2008.07.001
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© 2008 European Society of Cardiology

Urinary neutrophil gelatinase associated lipocalin (NGAL), a marker of tubular damage, is increased in patients with chronic heart failure

Kevin Dammana, Dirk J. van Veldhuisena, Gerjan Navisb, Adriaan A. Voorsa and Hans L. Hillegea,c,*

a Department of Cardiology, University Medical Center Groningen, University of Groningen Groningen, The Netherlands
b Department of Nephrology, University Medical Center Groningen, University of Groningen Groningen, The Netherlands
c Department of Epidemiology, University Medical Center Groningen, University of Groningen Groningen, The Netherlands

* Corresponding author. Department of Cardiology and Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO 30001, 9700 RB Groningen, The Netherlands. Tel.: +31503618066; fax: +31503618062. E-mail address: h.hillege{at}tcc.umcg.nl (H.L. Hillege).


  Abstract

Renal impairment, as measured by reduced glomerular filtration rate (GFR) and increased urinary albumin excretion (UAE), is prevalent in patients with chronic heart failure (CHF) and is associated with reduced survival. The prevalence of structural tubular damage in CHF is unknown. We investigated 90 CHF patients and 20 age and sex matched healthy controls, and determined estimated GFR, UAE, N terminal-pro brain natriuretic peptide (NT-proBNP) and urinary neutrophil gelatinase associated lipocalin (NGAL) as a marker for tubular damage. CHF patients had significantly lower averaged estimated GFR (64 ± 17 vs 90 ± 12 mL/min/1.73 m2, P<0.0001), but higher NT-proBNP and UAE levels (both P<0.0001). Median urinary NGAL levels were markedly increased in CHF patients compared to controls (175 (70–346) vs 37 (6–58) µg/gCr, P<0.0001). Both serum creatinine (r=0.26, P=0.006) and eGFR (r=–0.29, P=0.002) were significantly associated with urinary NGAL levels as were NT-proBNP and UAE but to a lesser extent. In conclusion, renal impairment in CHF patients is not only characterised by decreased eGFR and increased UAE, but also by the presence of tubular damage, as measured by increased urinary NGAL concentrations.

Key Words: Chronic heart failure • Renal function • Albuminuria • Tubular damage • NGAL • Neutrophil gelatinase associated lipocalin

Received December 28, 2007; Revised April 17, 2008; Accepted July 1, 2008


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