Neutrophil gelatinase-associated lipocalin (NGAL) is present in secondary granules of neutrophils and it is a relatively newly recognized marker of kidney diseases. The fibrinogen-to-albumin ratio (FAR) is a marker of inflammation but its diagnostic value has not been determined in sickle cell disease patients with kidney diseases. This study investigated the diagnostic roles of serum neutrophil gelatinase-associated lipocalin (sNGAL) and FAR for kidney diseases in steady-state adult sickle cell disease (SCD) patients. This study employed a prospective case-control design and recruited 104 SCD participants and 80 non-SCD patients. Participants' information was thoroughly documented using a structured questionnaire and patient case records. To evaluate the hematobiochemical parameters, 5 ml of venous blood was drawn from each participant and a clean catch of midstream urine was collected from each participant. The cases and controls were further categorized into microalbuminuria and non-microalbuminuria subjects, following three consecutive urine albumin-to-creatinine ratio (UACR) measurements. The prevalence of microalbuminuria was 32.7% among adult steady-state SCD patients. Significant higher levels of sNGAL and FAR were detected in SCD patients with microalbuminuria than in SCD patients without microalbuminuria and controls (p 5.72 µg/L yielding a high area under the curve (AUC = 0.854, p 0.09 also demonstrated significant predictive value (AUC = 0.630, p = 0.009) for kidney disease in SCD patients, with a moderate sensitivity (67.6%) and specificity (61.3%). Based on our findings, sNGAL could serve as an independent early predictor of kidney disease compared with urea and creatinine. Additionally, the fibrinogen-to-albumin ratio can be used as inflammatory marker for kidney diseases in SCD patients. Not applicable.
Twumasi et al. (Fri,) studied this question.