Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries
Snakebite-induced acute kidney injury (AKI) is frequently observed in patients following bites from vipers such as Russell’s viper (<i>Daboia russelii</i>) in India. Currently, the levels of serum creatinine are mainly used as a marker to determine the necessity for renal replacement the...
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2021
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oai:doaj.org-article:980efc9664414fa4a2bf963a565511ed2021-11-25T19:08:54ZNeutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries10.3390/toxins131107972072-6651https://doaj.org/article/980efc9664414fa4a2bf963a565511ed2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6651/13/11/797https://doaj.org/toc/2072-6651Snakebite-induced acute kidney injury (AKI) is frequently observed in patients following bites from vipers such as Russell’s viper (<i>Daboia russelii</i>) in India. Currently, the levels of serum creatinine are mainly used as a marker to determine the necessity for renal replacement therapy (RRT) (haemodialysis) in severe cases of AKI. However, it takes up to 48 h to ascertain a distinct change in creatinine levels compared to its baseline level upon admission. The time lost between admission and the 48 h timepoint significantly affects the clinical management of snakebite victims. Moreover, early diagnosis of AKI and decision on the necessity for RRT in snakebite victims is critical in saving lives, reducing long-term complications, and minimising treatment costs arising from expensive haemodialysis. Neutrophil gelatinase–associated lipocalin (NGAL) has been recently studied as a robust early marker for AKI in non-snakebite patients. However, its suitability for clinical use in snakebite victims has not been rigorously established. Here, we demonstrate the clinical significance of plasma NGAL as a robust marker for RRT following AKI using a large cohort (309) of Russell’s viper victims without any pre-existing health conditions. NGAL levels upon admission are positively correlated with creatinine levels at 48 h in different stages of AKI. Overall, NGAL acts as a robust early marker to ascertain the need for RRT following Russell’s viper bites. The quantification of NGAL can be recommended as a routine test in hospitals that treat snakebites to decide on RRT at early time points instead of waiting for 48 h to confirm the increase in creatinine levels. The diagnostic use of NGAL in Russell’s viper victims with pre-existing comorbidities and for other vipers should be evaluated in future studies.Subramanian SenthilkumaranKetan PatelAnika SalimPradeep VijayakumarHarry F. WilliamsRajendran VaiyapuriRavi SavaniaNamasivayam ElangovanPonniah ThirumalaikolundusubramanianM. Fazil BakshSakthivel VaiyapuriMDPI AGarticlesnakebite envenomationRussell’s viperviper bitesacute kidney injuryrenal biomarkerneutrophil gelatinase–associated lipocalinMedicineRENToxins, Vol 13, Iss 797, p 797 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
snakebite envenomation Russell’s viper viper bites acute kidney injury renal biomarker neutrophil gelatinase–associated lipocalin Medicine R |
| spellingShingle |
snakebite envenomation Russell’s viper viper bites acute kidney injury renal biomarker neutrophil gelatinase–associated lipocalin Medicine R Subramanian Senthilkumaran Ketan Patel Anika Salim Pradeep Vijayakumar Harry F. Williams Rajendran Vaiyapuri Ravi Savania Namasivayam Elangovan Ponniah Thirumalaikolundusubramanian M. Fazil Baksh Sakthivel Vaiyapuri Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries |
| description |
Snakebite-induced acute kidney injury (AKI) is frequently observed in patients following bites from vipers such as Russell’s viper (<i>Daboia russelii</i>) in India. Currently, the levels of serum creatinine are mainly used as a marker to determine the necessity for renal replacement therapy (RRT) (haemodialysis) in severe cases of AKI. However, it takes up to 48 h to ascertain a distinct change in creatinine levels compared to its baseline level upon admission. The time lost between admission and the 48 h timepoint significantly affects the clinical management of snakebite victims. Moreover, early diagnosis of AKI and decision on the necessity for RRT in snakebite victims is critical in saving lives, reducing long-term complications, and minimising treatment costs arising from expensive haemodialysis. Neutrophil gelatinase–associated lipocalin (NGAL) has been recently studied as a robust early marker for AKI in non-snakebite patients. However, its suitability for clinical use in snakebite victims has not been rigorously established. Here, we demonstrate the clinical significance of plasma NGAL as a robust marker for RRT following AKI using a large cohort (309) of Russell’s viper victims without any pre-existing health conditions. NGAL levels upon admission are positively correlated with creatinine levels at 48 h in different stages of AKI. Overall, NGAL acts as a robust early marker to ascertain the need for RRT following Russell’s viper bites. The quantification of NGAL can be recommended as a routine test in hospitals that treat snakebites to decide on RRT at early time points instead of waiting for 48 h to confirm the increase in creatinine levels. The diagnostic use of NGAL in Russell’s viper victims with pre-existing comorbidities and for other vipers should be evaluated in future studies. |
| format |
article |
| author |
Subramanian Senthilkumaran Ketan Patel Anika Salim Pradeep Vijayakumar Harry F. Williams Rajendran Vaiyapuri Ravi Savania Namasivayam Elangovan Ponniah Thirumalaikolundusubramanian M. Fazil Baksh Sakthivel Vaiyapuri |
| author_facet |
Subramanian Senthilkumaran Ketan Patel Anika Salim Pradeep Vijayakumar Harry F. Williams Rajendran Vaiyapuri Ravi Savania Namasivayam Elangovan Ponniah Thirumalaikolundusubramanian M. Fazil Baksh Sakthivel Vaiyapuri |
| author_sort |
Subramanian Senthilkumaran |
| title |
Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries |
| title_short |
Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries |
| title_full |
Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries |
| title_fullStr |
Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries |
| title_full_unstemmed |
Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries |
| title_sort |
neutrophil gelatinase–associated lipocalin acts as a robust early diagnostic marker for renal replacement therapy in patients with russell’s viper bite–induced acute kidney injuries |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/980efc9664414fa4a2bf963a565511ed |
| work_keys_str_mv |
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