Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.111343
Revised: July 18, 2025
Accepted: October 30, 2025
Published online: December 25, 2025
Processing time: 178 Days and 21.5 Hours
Acute kidney injury (AKI) is a severe complication of acute pancreatitis (AP) associated with increased morbidity and mortality. Early prediction of AKI remains a clinical challenge owing to the limitations of traditional biomarkers, such as serum creatinine.
To evaluate the concentration and predictive value of plasma neutrophil gelati
This cross-sectional descriptive study was conducted from October 2021 to June 2023 at Bach Mai Hospital. In total, 219 patients were enrolled, including 51 patients with AP and AKI, 168 patients with AP but without AKI, and 35 healthy controls. Plasma NGAL levels were measured and compared between groups. Receiver operating characteristic curve analysis was performed to determine the predictive value of NGAL levels for the severity of AKI and AP.
Among AP and AKI cases, 47.1% were classified as Kidney Disease: Improving Global Outcomes stage 1, 33.3% as stage 2, and 19.6% as stage 3. The AP with AKI group (570.9 ng/mL) had significantly higher median plasma NGAL concentrations than the AP without AKI group (400.6 ng/mL) and the healthy control group (234.3 ng/mL) (P < 0.01). The NGAL levels increased proportionally with AKI severity. A plasma NGAL cutoff value of 504.29 ng/mL predicted AKI with 60.8% sensitivity and 68.4% specificity (area under the curve = 0.684; P < 0.001). A cutoff of 486.03 ng/mL predicted AP severity with 66.1% sensitivity and 66.4% specificity (area under the curve = 0.651; P < 0.005). NGAL positively correlated with international normalized ratio, urea, creatinine, lactate dehydrogenase, and lactate levels.
Plasma NGAL levels predicted both AKI development and disease severity. Therefore, NGAL should be consi
Core Tip: Severe acute pancreatitis (AP) is frequently associated with multiple complications, including acute kidney injury (AKI). In clinical practice, the early diagnosis of AKI remains challenging. This study provides evidence of the value of plasma neutrophil gelatinase-associated lipocalin in predicting the occurrence of AKI, assessing the severity of AP, and forecasting the need for continuous renal replacement therapy in patients with AP complicated by AKI. Additionally, we analyzed the correlation between plasma neutrophil gelatinase-associated lipocalin levels and clinical and paraclinical characteristics.