NGAL 1.1

  • Research type

    Research Study

  • Full title

    Assessment of plasma and urine NGAL for the early prediction of acute kidney injury after cardiac surgery in adults

  • IRAS ID

    194526

  • Contact name

    Rousseau Gama

  • Contact email

    rousseau.gama@nhs.net

  • Sponsor organisation

    Royal Wolverhampton NHS Trust

  • Duration of Study in the UK

    2 years, 0 months, 0 days

  • Research summary

    Adult heart surgery enhances quality of life and is often life-saving but it has risks. One such risk is acute kidney injury (AKI) which is when the kidneys become damaged and are unable to properly remove deadly toxins from the blood. It affects 100-200 patients/year in our unit and about half will require dialysis which involves using a machine to remove these toxins. AKI is associated with a six-fold increased risk of death, a poorer quality of life, a longer stay in hospital and increased NHS costs. Most patients recover but some may be left with permanent kidney damage requiring lifelong treatment.

    AKI is currently diagnosed by detecting a rise in blood creatinine levels. This test, however, is not effective because it can take 24-48hrs for levels to rise after kidney damage by which time the kidneys may have lost half their function. A test predicting AKI sooner would allow doctors to start treatment earlier to prevent AKI. Neutrophil gelatinase-associated lipocalin (NGAL) is potentially such a test. NGAL rises in both blood and urine 2-6 hours following kidney damage, enabling much earlier identification of patients at risk of developing AKI who may then benefit from treatment to prevent it. Studies on NGAL have focussed on people with normal kidneys and no other medical problems which does not reflect the heart surgery patients seen in Wolverhampton or other units. We will therefore evaluate whether NGAL predicts AKI in a “real-world” hospital setting like ours.

    We will compare two different NGAL tests using samples collected from patients undergoing heart surgery in our unit in order to find out which is superior and whether it is better to use blood or urine for the test. We will include patients who already have kidney or any other medical problems. If successful, we would put a local system in place in our unit to help detect and treat AKI earlier to reduce the associated complications, improve patient care and outcomes and shorten the time in hospital.

  • REC name

    West Midlands - Coventry & Warwickshire Research Ethics Committee

  • REC reference

    16/WM/0440

  • Date of REC Opinion

    15 Nov 2016

  • REC opinion

    Further Information Favourable Opinion