Neutrophil gelatinase-associated lipocalin (NGAL) as a marker of kidney damage

Am J Kidney Dis. 2008 Sep;52(3):595-605. doi: 10.1053/j.ajkd.2008.01.020. Epub 2008 Apr 2.


Neutrophil gelatinase-associated lipocalin (NGAL) is a protein belonging to the lipocalin superfamily initially found in activated neutrophils, in accordance with its role as an innate antibacterial factor. However, it subsequently was shown that many other types of cells, including in the kidney tubule, may produce NGAL in response to various injuries. The increase in NGAL production and release from tubular cells after harmful stimuli of various kinds may have self-defensive intent based on the activation of specific iron-dependent pathways, which in all probability also represent the mechanism through which NGAL promotes kidney growth and differentiation. NGAL levels predict the future appearance of acute kidney injury after treatments potentially detrimental to the kidney and even the acute worsening of unstable nephropathies. Furthermore, recent evidence also suggests that NGAL somehow may be involved in the pathophysiological process of chronic renal diseases, such as polycystic kidney disease and glomerulonephritis. NGAL levels clearly correlate with severity of renal impairment, probably expressing the degree of active damage underlying the chronic condition. For all these reasons, NGAL may become one of the most promising next-generation biomarkers in clinical nephrology and beyond.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Acute-Phase Proteins / metabolism*
  • Acute-Phase Proteins / urine
  • Biomarkers / blood
  • Biomarkers / metabolism
  • Biomarkers / urine
  • Cardiac Surgical Procedures / adverse effects
  • Chronic Disease
  • Humans
  • Kidney / growth & development
  • Kidney / metabolism
  • Kidney Diseases / blood
  • Kidney Diseases / etiology
  • Kidney Diseases / metabolism*
  • Kidney Diseases / urine
  • Lipocalin-2
  • Lipocalins / blood
  • Lipocalins / metabolism*
  • Lipocalins / urine
  • Predictive Value of Tests
  • Proto-Oncogene Proteins / blood
  • Proto-Oncogene Proteins / metabolism*
  • Proto-Oncogene Proteins / urine


  • Acute-Phase Proteins
  • Biomarkers
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Proto-Oncogene Proteins