NGAL Workshop – Why All the Hype?

Alpha Laboratories’ Industry Sponsored Workshop at the ACB FOCUS 2013 Meeting in York last month attracted over 50 participants. The event was reviewed by Dr Ruth Ayling – Consultant Biochemist, Derriford Hospital, Plymouth:

This workshop brought together Dr Andreas Peter from the Division of Endocrinology and Metabolism, University of Tubingen, Germany and Professor Roy Sherwood from the Department of Clinical Biochemistry, King’s College Hospital.

Dr Peter described the use of NGAL within a University Hospital transplant centre. He demonstrated the merits of the NGAL test as a diagnostic test in the differential diagnosis of acute kidney injury (AKI) following renal transplant, using illustrative case histories. For this he used cut offs determined in his own laboratory.

Professor Sherwood presented studies investigating the use of NGAL in patients undergoing cardiac interventions  and with liver disease. He found that NGAL was a potentially useful marker of AKI after transcatheter aortic valve insertion (TAVI). In cirrhosis and after liver transplant NGAL was superior to serum creatinine or eGFR in predicting AKI. A correlation with C-reactive protein was noted but the mechanism not explained.

With reference to the title of the workshop, my online dictionary gives one definition of hype as “questionable claim” The speakers certainly provided evidence to suggest that NGAL shows promise as a biomarker.  However, there remain uncertainties about the mechanisms of its secretion in response to the renal insult. Further studies might enable this to be elucidated and the diagnostic potential of NGAL to be clarified.