NEUTROPHIL GELATINASE - ASSOCIATED LIPOCALIN (NGAL) IN RELATION TO RENAL ANEMIAOF HEMODIALYSIS PATIENTS

Iron status in anemic chronic HD patients was primarily assessed by serum ferritin and T ransferrin saturation (T SAT ) . Recent evaluation revealed that serum ferritin is a less reliable index of iron storage in HD patients. NGAL has been found to have a role in iron metabolism and is an early marker for AKI. Its level was prognostic to predict initiation of renal replacement therapy. The present study is a trial to evaluate NGAL as a biomarker of renal anemia in chronic HD patients. It is conducted on 40 HD patients and 20 healthy control subjects. They are divided in to 2 groups: Group 1 (healthy control group) with Hb > 13g/dL and Group 2 (40 ESRD patients on regular HD thrice weekly). Group 2 is further subdivided into group 2A (20 cases with Hb < 11 g/dl) and group 2B (20 cases with Hb < 13 g/dl and ? 11 g/dl). Blood samples are collected from all these individuals to measure Hb, total serum iron, serum ferritin, TSAT%, CRP and NGAL. Compared to the control group, the results of the ESRD patients on HD (group 2A and 2B) show significantly lower serum iron levels (p < 0.001), higher serum ferritin (p < 0.05 and p < 0.001, respectively, lower TSAT% (p < 0.001 and p > 0.05, respectively), higher CRP (p < 0.001) and higher serum NGAL (p < 0.001 and p < 0.01, respectively). Correlation studies show: 1) Significantly strong direct correlation between serum CRP and ferritin (r = 0.637, p < 0.001); 2) Significantly strong inverse correlation (p < 0.001) b etween NGAL and Hb (r = - 0.631), between NGAL and iron (r = - 0.578), and between NGAL and TSAT% (r = - 0.446); 3) No significant correlation between NGAL and ferritin (r = 0.244, p > 0.05).In conclusion, NGAL may be useful as a potential biomarker in ass essment of renal anemia among HD patients