Renal expression of neutrophil gelatinase-associated lipocalin (NGAL) increses dramatically after renal ischemia orexposure to nephrotoxic agents. The usefulness of NGAL as a marker of renal injury leading to acute renal failure (ARF) has previously been demonstrated in patient groups that have few confounding factors such as sepsis or cancer. The aim of the present study was to test the usefulness of NGAL levels for predicting a requirement for renal replacement therapy (RRT) in unselected critically ill patients admitted to intensive care.

Renal expression of neutrophil gelatinase-associated lipocalin (NGAL) increases dramatically after renal ischemia or exposure to nephrotoxic agents. This is reflected by the rapid rise in urinary NGAL reported in children who developed acute renal failure (ARF) after cardiac surgery. The aim of the present study was to ascertain whether urine or plasma NGAL levels, determined by a recently developed ELISA, are useful for diagnosing renal injury leading to ARF in unselected critically ill patients admitted to intensive care.