Table 1.

NGAL as an AKI biomarker

Biomarker property	NGAL
Specific to AKI (AKI versus CKD versus systemic disease)	+/−a
Discern AKI sub-types (pre-renal azotemia versus intrinsic AKI)	Yes
Sensitive to establish an early diagnosis	Yes
Conserved across species	Yes
High gradient to allow early and easy detection	Yes
Proportional increase with injury or loss of function	Yes
Associated with a known mechanism	Yes
Results available while damage is limitable	Yes
Results predict clinical outcomes	Yes
Practical to measure	Yes
Amendable to existing platform assay methods	Yes

^aPlasma NGAL may be detected in chronic kidney disease (CKD), chronic hypertension, systemic infections, inflammatory conditions and malignancies [51–56]. Urine NGAL may be detected in CKD, lupus nephritis and urinary tract infections [57–60]. In all these situations, NGAL values are generally substantially blunted compared to those typically measured in AKI.