Type of test Blood
Normal findings
No rise in NGAL from baseline.
Test explanation and related physiology
NGAL is a predictor for acute kidney injury (AKI), previously referred to as acute renal failure, and chronic kidney disease (CKD). There are no early markers for acute or chronic renal disease. This is particularly important in patients who have serious nonrenal disease (e.g., heart surgery, renal transplant, sepsis). In these patients, severe AKI increases morbidity and mortality of hospitalized patients.
A marked elevation in NGAL indicates that renal injury has occurred. NGAL concentrations rise 48 hours before a rise in creatinine is noted. NGAL can be detected in both urine and blood within 2 hours of a renal insult.
NGAL can be measured in the urine, plasma, or serum samples with enzyme-linked immunosorbent assay (ELISA) test kits. Results are available in less than 1 hour. Normal values vary according to which laboratory method is used and the patient’s baseline glomerular filtration rate (GFR). NGAL varies inversely with the GFR.
NGAL measurements are being used increasingly in a variety of clinical situations leading to AKI (e.g., during cardiac surgery, kidney transplantation, contrast nephropathy, and hemolytic uremic syndrome) and in the intensive care setting. They are also useful in conditions leading to CKD (e.g., lupus nephritis, glo merulonephritis, and obstruction).
Procedure and patient care
• See inside front cover for Routine Blood Testing.
• Fasting: no
• Blood tube commonly used: red
• Collect urine specimens at the same time each day for consecutive days.
• Results are compared with previous day’s testing.
Abnormal findings
Increased levels
- Primary or secondary renal disease
