Clinical and Experimental Medicine

, Volume 18, Issue 4, pp 563–568 | Cite as

Increased NGAL level associated with iron store in chronic kidney disease with anemia

  • Daijun Xiang
  • Xiuying Wang
  • Peipei Liu
  • Yuling Pan
  • Qian Zhang
  • Xiuping Chi
  • Ying Jing
  • Xinxin Duan
  • Qiaozhen Wei
  • Jianan Wang
  • Mianyang LiEmail author
  • Chengbin WangEmail author
Original Article


An iron scarcity often occurs in chronic kidney disease (CKD). Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of acute kidney injury, is associated with iron metabolism. The present study determined the association between serum NGAL and iron status in chronic kidney disease with anemia. A total of 154 adult CKD patients were divided into anemia and without anemia groups. The anemia groups were further subdivided into two groups based on the presence or absence of iron deficiency, defined as a transferrin saturation (TSAT) < 20%. The NGAL was measured for all the 154 patients, and the possible relationships with iron status were analyzed. 27.7% patients with TSAT < 20% presented lower hemoglobin, serum iron, serum ferritin, and higher NGAL values than those without iron deficiency. NGAL was inversely correlated with hemoglobin, hematocrit, MCV, MCH, serum iron, and TSAT. NGAL adequately diagnosed the status of iron deficiency among CKD patients by ROC analysis. The optimal NGAL cutoff value able to identify iron deficiency was found to be > 244.8 ng/mL, with 73.01% sensitivity and 68.29% specificity. CKD patients with anemia presented altered NGAL values as this protein is involved in the maintenance of iron balance. Thus, NGAL might be proposed as a new tool for assessing the iron deficiency and in the management of iron therapy for CKD patients.


NGAL Chronic kidney disease Anemia Iron store 



The present study was supported by the Capital Laboratory Medicine Characteristic Clinic Project (z121107005112010), and the PLA General Hospital Clinical Support Fund Program (2016FC-TSYS-1041).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Clinical LaboratoryChinese PLA General HospitalBeijingChina
  2. 2.Department of NeurosurgeryChinese PLA General HospitalBeijingChina

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