NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease

Kidney Int. 2012 Sep;82(6):718-22. doi: 10.1038/ki.2012.195. Epub 2012 Jun 13.


The type and the extent of tissue damage inform the prognosis of chronic kidney disease (CKD), but kidney biopsy is not a routine test. Urinary tests that correlate with specific histological findings might serve as surrogates for the kidney biopsy. We used immunoblots and ARCHITECT-NGAL assays to define the immunoreactivity of urinary neutrophil gelatinase-associated lipocalin (NGAL) in CKD, and we used mass spectroscopy to identify associated proteins. We analyzed kidney biopsies to determine whether specific pathological characteristics associated with the monomeric NGAL species. Advanced CKD urine contained the NGAL monomer as well as novel complexes of NGAL. When these species were separated, we found a significant correlation between the NGAL monomer and glomerular filtration rate (r=-0.53, P<0.001), interstitial fibrosis (mild vs. severe disease; mean 54 vs. 167 μg uNGAL/g Cr, P<0.01), and tubular atrophy (mild vs. severe disease; mean 54 vs. 164 μg uNGAL/g Cr, P<0.01). Monospecific assays of the NGAL monomer demonstrated a correlation with histology that typifies progressive, severe CKD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins / urine*
  • Adult
  • Aged
  • Atrophy
  • Biomarkers / urine
  • Biopsy
  • Blotting, Western
  • Cation Exchange Resins
  • Chi-Square Distribution
  • Chromatography, Gel
  • Chromatography, Ion Exchange
  • Disease Progression
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fibrosis
  • Glomerular Filtration Rate
  • Humans
  • Kidney / pathology*
  • Kidney / physiopathology
  • Lipocalin-2
  • Lipocalins / urine*
  • Male
  • Mass Spectrometry
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Proteinuria / diagnosis
  • Proteinuria / pathology
  • Proteinuria / urine
  • Proto-Oncogene Proteins / urine*
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / pathology
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / urine
  • Severity of Illness Index
  • Urinalysis


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