Novel biomarkers: help or hindrance to patient care in the emergency department?

EDITOR'S CAPSULE SUMMARY FOR SHAPIRO ET AL WHAT IS ALREADY KNOWN ON THIS TOPIC: Acute kidney injury is common in severe infection. At present, there are no biomarkers that accurately detect its presence before increase of the creatinine level. WHAT QUESTION THIS STUDY ADDRESSED: This 661-patient observational study tested the diagnostic performance of neutrophil gelatinase-associated lipocalin (NGAL) to detect acute kidney injury in emergency department patients with suspected infection. WHAT THIS STUDY ADDS TO OUR KNOWLEDGE: Plasma concentrations of NGAL greater than 150 ng/dL were 96% sensitive and 51% specific for acute kidney injury occurring within the first 72 hours of hospitalization. HOW THIS MIGHT CHANGE CLINICAL PRACTICE: These preliminary results should not change clinical practice but suggest that NGAL may be useful for identifying patients at risk for acute kidney injury.