Predictive value of serum NGAL levels in patients with chronic renal insufficiency after renal transplantation
Objective To investigate the predictive value of serum neutrophil gelatinase asso-ciated lipid transporter(NGAL)levels in patients with chronic renal insufficiency after renal transplan-tation.Methods The clinical data of 103 patients who underwent kidney transplantation in Nanchong Central Hospital from May 2018 to May 2021 were retrospectively analyzed.All patients were divided into normal renal function group(54 cases)and renal insufficiency group(49 cases)according to whether renal insufficiency during 1-year follow-up after surgery.The general data before surgery and serum NGAL after surgery of donors and recipients between the two groups were compared.Multifactor logistic regression analysis was used to obtain independent predictors of renal insufficiency during 1-year follow-up after renal transplantation,the analysis was focused on the correlation between postoper-ative serum NGAL and renal insufficiency in patients during 1-year follow-up after surgery,the receiver operating characteristics(ROC)curve and decision curve of independent predictors were drawn to pre-dict renal insufficiency in patients during 1-year follow-up after surgery,and to verify their predictive value.Results The age,body mass index(BMI),triglycerides(TG),cholesterol(TC),low-densi-ty lipoprotein(LDL),serum NGAL,and cystatin C(Cys C)of patients with renal insufficiency were significantly higher than those of patients in normal renal function(all P＜0.05).The results of multi-variate logistic regression analysis showed that age,TG,LDL,and serum NGAL were independent in-fluencing factors of the occurrence of renal insufficiency in kidney transplant patients during 1-year fol-low-up(all P＜0.05).The risk of renal insufficiency in kidney transplant patients increased by 1.947 times for every 1 ng/mL increase in serum NGAL(OR=2.947,95％CI:1.621-3.945,P＜0.001).ROC analysis results showed that when the age≥50.3 years,TG≥2.0 mmol/L,LDL≥3.2 mmol/L,and postoperative serum NGAL ≥157.1 ng/mL,it could be used as a sign of renal insufficiency in re-nal transplant patients during 1-year follow-up.The area under the curve(AUC)of predicting renal insufficiency in renal transplant patients during 1-year follow-up were 0.783(95％Cl:0.621-0.845),0.742(95％CI:0.689-0.791),0.753(95％CI:0.717-0.811),and 0.882(95％CI:0.811-0.912),respectively,the maximum AUC of joint prediction was 0.945(95％CI:0.919-0.986).The results of decision curve analysis showed that age,TG,LDL and serum NGAL had good net re-turns in predicting renal insufficiency in renal transplant patients during 1-year follow-up.Conclusions The change of serum NGAL level after renal transplantation can predict renal insufficiency in renal transplant patients in advance in comparison which has higher predictive value and clinical application.
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