caa a22 4500 606220496 CHVBK 20210128101124.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s00380-013-0454-7 doi (NATIONALLICENCE)springer-10.1007/s00380-013-0454-7 Urinary neutrophil gelatinase-associated lipocalin as a predictor of cardiovascular events in patients with chronic kidney disease [Elektronische Daten] [Midori Hasegawa, Junichi Ishii, Fumihiko Kitagawa, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Makoto Tomita, Hiroshi Takahashi, Yukio Ozaki, Yukio Yuzawa] Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular (CV) events. Recently, elevated neutrophil gelatinase-associated lipocalin (NGAL) levels have been reported in patients with heart failure, coronary heart disease, or stroke. Our aim was to assess urinary NGAL as a predictor of CV events in patients with CKD. This was a prospective observational cohort study of 404 patients with predialysis CKD. CV events were defined as CV death, acute coronary syndrome, hospitalization for worsening heart failure, stroke and dissection of aorta. During a mean follow-up period of 33 months, 77 CV events (19.1 %) occurred. After adjustment for gender, age, diabetes, previous cardiovascular disease, urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate, hemoglobin, and high-sensitivity C-reactive protein, patients with the other quartiles of urinary NGAL had significantly higher risk of CV events compared with patients with the lowest quartile (hazard ratio (HR) 2.81, 95 % confidence interval (CI) 1.01-7.81, P = 0.047 for Q2, HR 3.31, 95 % CI 1.22-9.00, P = 0.019 for Q3, and HR 3.27, 95 % CI 1.15-9.29, P = 0.026 for Q4). Regarding the combination of urinary NGAL with UACR, we also stratified patients into four groups according to whether the level of each marker was above or below the median (61.8 μg per gram creatinine (gCr) for NGAL and 351.1 mg/gCr for UACR). Four-year CV event-free survival rates were 89.2, 79.6, 71.8, and 51.5 % in order for the four respective groups (P < 0.0001). Elevated urinary NGAL was able to predict future CV events in CKD patients, and had incremental predictive value with elevated UACR. Springer Japan, 2013 Neutrophil gelatinase-associated lipocalin nationallicence Cardiovascular event nationallicence Chronic kidney disease nationallicence Hasegawa Midori Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut Ishii Junichi Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan aut Kitagawa Fumihiko Laboratory of Clinical Medicine, Fujita Health University, Toyoake, Japan aut Takahashi Kazuo Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut Hayashi Hiroki Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut Koide Shigehisa Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut Tomita Makoto Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut Takahashi Hiroshi Division of Medical Statistics, Fujita Health University, Toyoake, Japan aut Ozaki Yukio Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan aut Yuzawa Yukio Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut Heart and Vessels Springer Japan 30/1(2015-01-01), 81-88 0910-8327 30:1<81 2015 30 380 https://doi.org/10.1007/s00380-013-0454-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-013-0454-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hasegawa Midori Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut NATIONALLICENCE 700 1- Ishii Junichi Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan aut NATIONALLICENCE 700 1- Kitagawa Fumihiko Laboratory of Clinical Medicine, Fujita Health University, Toyoake, Japan aut NATIONALLICENCE 700 1- Takahashi Kazuo Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut NATIONALLICENCE 700 1- Hayashi Hiroki Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut NATIONALLICENCE 700 1- Koide Shigehisa Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut NATIONALLICENCE 700 1- Tomita Makoto Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut NATIONALLICENCE 700 1- Takahashi Hiroshi Division of Medical Statistics, Fujita Health University, Toyoake, Japan aut NATIONALLICENCE 700 1- Ozaki Yukio Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan aut NATIONALLICENCE 700 1- Yuzawa Yukio Department of Nephrology, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutukaek-cho, 470-1192, Toyoake, Aichi, Japan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/1(2015-01-01), 81-88 0910-8327 30:1<81 2015 30 380