{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:40:18Z","timestamp":1792176018188,"version":"4.4.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims:<\/jats:title>\n            <jats:p>Acute kidney injury (AKI) commonly occurs in patients with decompensated cirrhosis. Urinary neutrophil gelatinase\u2013associated lipocalin (uNGAL) could help discriminate between different etiologies of AKI. The aim of this study was to investigate the use of uNGAL in (1) the differential diagnosis of AKI, (2) predicting the response to terlipressin and albumin in patients with hepatorenal syndrome\u2010AKI (HRS\u2010AKI), and (3) predicting in\u2010hospital mortality in patients with AKI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results:<\/jats:title>\n            <jats:p>One hundred sixty\u2010two consecutive patients with cirrhosis and AKI were included from 2015 to 2020 and followed until transplant, death, or 90\u2009days. Standard urinary markers and uNGAL were measured. Data on treatment, type, and resolution of AKI were collected. Thirty\u2010five patients (21.6%) had prerenal AKI, 64 (39.5%) HRS\u2010AKI, 27 (16.7%) acute tubular necrosis\u2010AKI (ATN\u2010AKI), and 36 (22.2%) a mixed form of AKI. Mean values of uNGAL were significantly higher in ATN\u2010AKI than in other types of AKI (1162\u2009ng\/ml [95% CI 423\u20132105\u2009ng\/ml] vs. 109\u2009ng\/ml [95% CI 52\u2013192\u2009ng\/ml]; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0&lt;\u20090.001). uNGAL showed a high discrimination ability in predicting ATN\u2010AKI (area under the receiver operating characteristic curve, 0.854; 95% CI 0.767\u20130.941; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0&lt;\u20090.001). The best\u2010performing threshold was found to be 220\u2009ng\/ml (sensitivity, 89%; specificity, 78%). The same threshold was independently associated with a higher risk of nonresponse (adjusted OR [aOR], 6.17; 95% CI 1.41\u201327.03; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u20090.016). In multivariable analysis (adjusted for age, Model for End\u2010Stage Liver Disease, acute\u2010on\u2010chronic liver failure, leukocytes, and type of AKI), uNGAL was an independent predictor of in\u2010hospital mortality (aOR, 1.74; 95% CI 1.26\u20132.38; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>uNGAL is an adequate biomarker for making a differential diagnosis of AKI in cirrhosis and predicting the response to terlipressin and albumin in patients with HRS\u2010AKI. In addition, it is an independent predictor of in\u2010hospital mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32799","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T10:18:35Z","timestamp":1663669115000},"page":"1630-1638","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":69,"title":["Diagnostic and prognostic performance of urinary neutrophil gelatinase\u2010associated lipocalin in patients with cirrhosis and acute kidney injury"],"prefix":"10.1097","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9376-1527","authenticated-orcid":false,"given":"Carmine","family":"Gambino","sequence":"first","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9356-5830","authenticated-orcid":false,"given":"Salvatore","family":"Piano","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Stenico","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Tonon","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Brocca","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Calvino","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Incicco","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Zeni","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Gagliardi","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cosma","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Unit, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Zaninotto","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Unit, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Burra","sequence":"additional","affiliation":[{"name":"Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Cillo","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Basso","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Unit, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Angeli","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"issue":"1","key":"hep32799-bib-0001-20250824","article-title":"Hepatorenal syndrome","volume":"4","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"3","key":"hep32799-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.cgh.2016.09.156","article-title":"Validation of a staging system for acute kidney injury in patients with cirrhosis and association with acute\u2010on\u2010chronic liver failure","volume":"15","year":"2017","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"hep32799-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.jhep.2013.04.036","article-title":"A modified acute kidney injury classification for diagnosis and risk stratification of impairment of kidney function in cirrhosis","volume":"59","year":"2013","journal-title":"J Hepatol"},{"issue":"3","key":"hep32799-bib-0004-20250824","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.jhep.2013.03.039","article-title":"Evaluation of the Acute Kidney Network criteria in hospitalized patients with cirrhosis and ascites","volume":"59","year":"2013","journal-title":"J Hepatol"},{"issue":"4","key":"hep32799-bib-0005-20250824","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.jhep.2014.12.029","article-title":"Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites","volume":"62","year":"2015","journal-title":"J Hepatol"},{"issue":"2","key":"hep32799-bib-0006-20250824","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","article-title":"EASL clinical practice guidelines for the management of patients with decompensated cirrhosis","volume":"69","year":"2018","journal-title":"J Hepatol"},{"issue":"1","key":"hep32799-bib-0007-20250824","first-page":"164","article-title":"Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. 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Fail"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep.32799","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep.32799","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep.32799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T22:10:53Z","timestamp":1756073453000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep.32799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,17]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.32799","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2023,4,17]]},"assertion":[{"value":"2022-06-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}