Abstract
OBJECTIVE: To investigate the effect of neutrophil gelatinase-associated lipocalin (NGAL) on prognosis of patients with type 2 hepatorenal syndrome (HRS). METHODS: A total of 54 patients with type 2 HRS were included in the study, and stratified for analysis according to survival status at 6-month followup:survival group, n=25; death group, n=29. Single factor analysis was used to compare the betweengroup differences for levels of plasma NGAL, urine NGAL, renin, aldosterone, and blood biochemical indicators. The Cox proportional hazard regression model was used to assess the prognosis of patients with type 2 HRS. The F-test, t-test, chi-square test, Pearson's correlation analysis, and Cox regression model were used for the statistical analyses. RESULTS: The HRS patients with liver cirrhosis showed significantly lower levels of hemoglobin, platelets and albumin (all P < 0.05), but significantly higher international normalized ratio and levels of aspartate aminotransferase, alanine arninotransferase, total bilirubin, direct bilirubin, serum creatinine, plasma NGAL, urine NGAL, renin and aldosterone (all P < 0.05). Plasma NGAL and urine NGAL were positively correlated with renin, aldosterone, blood creatinine, MELD score, Child-Pugh score and ascites (P < 0.05). The patients in the 6-month survival group showed significantly lower levels of albumin, serum sodium, serum creatinine, plasma NGAL, urine NGAL, renin, and aldosterone than those in the death group (P < 0.05), but significantly higher glomerular filtration rate (vs. death group, P < 0.05). The Cox proportional hazard regression model showed that MELD, plasma NGAL, total bilirubin and creatinine were influencing factors of 6-month prognosis for patients with type 2 HRS (relative risk: 1.214, 1.157, 1.098 and 1.016 respectively). CONCLUSION: Plasma NGAL is high in patients with type 2 FHRS, and is associated with risk of death.