Use of plasma neutrophil gelatinas associated lipocalin level to identify critical patients with acute kidney injury that require renal replacement therapy: is it a reliable biomarker?

High levels of plasma neutrophil gelatinase associated lipocalin (pNGAL) have been reported to show strong correlation with renal replacement therapy (RRT) for patients with acute kidney injury (AKI). Current literature outlines several benefits and associated risks of RRT in intensive care unit (ICU) (1). However the proposed parameters for starting RRT are inconsistent such as the use of blood urea nitrogen and serum creatinine. Also the duration of RRT in AKI for ICU patients is not clearly defined (2). pNGAL has been reported as a reliable novel AKI biomarker (3). This study aims to find the use of pNGAL level to identify high-risk AKI patients before starting RRT and also using the level of pNGAL as a monitoring tool for renal recovery in critical care settings.