Neutrophil gelatinase-associated lipocalin as an early predictor of delayed graft function

Delayed graft function occurs in about 20 to 50 percent of kidney transplants. To describe the behavior of urinary neutrophil gelatinase-associated lipocalin (NGALu) in deceased-donor renal transplant recipients and to compare this indicator with the percentage of creatinine decrease (PdC) for the early detection of delayed graft function. NGALu levels were evaluated in a prospective cohort in the first, 12th, 24th and 48th hours after kidney transplant, and compared with the daily PdC until day 5. We included 79 patients in the study. Delayed graft function occurred in 13 patients (16.5%), and five patients (6.3%) required dialysis in the first week. NGALu levels at all cut-off points were higher in patients with delayed graft function (p=0.526, p=0.049, p=0.032, and p=0.001). NGALu levels above 120 ng/ml at 48 hours predicted delayed graft function with a sensitivity of 75% and a specificity of 71%. A PdC of 59.5% best discriminated the delayed graft function, with a sensitivity of 92% and a specificity of 83% at 48 hours. Using logistic regression for the adjusted delayed graft function, the only significant values to predict it were those of PdC. NGALu levels measured at 48 hours after renal transplantation predicted delayed graft function, including the need for dialysis; however, this marker was not superior to the PdC for early detection.