Early detection of urinary tract obstruction (UTO) is critical for avoiding the mortality and morbidity associated with acute kidney injury (AKI) and the progression to permanent kidney damage. Urinary biomarkers like neutrophil gelatinase-associated lipocalin (NGAL) have been identified as an accurate tool in the prompt diagnosis of AKI, but their function in the detection, prognosis, and subsequent monitoring of a range of obstructive uropathies has yet to be investigated. Therefore, from conception until August 2021, researchers, for a study, conducted a systematic review of the literature using Cochrane methods.
About 11 trials (616 individuals) with diverse UTO aetiologies were included in which urine and serum NGAL were assessed. Around 4 research focused solely on kidney stone disease (KSD), whereas other investigations discovered various causes of UTO such as pelvic ureteric junction obstruction (PUJO), retroperitoneal fibrosis (RPF), and ureteric strictures. Nearly 6 studies looked at NGAL levels following a surgical procedure to remove the blockage. About 9 studies found a substantial rise in urine and serum NGAL levels in UTO, which was generally more sensitive and timely than serum creatinine. Urinary NGAL levels might detect subclinical unilateral UTO even in the absence of alterations in serum creatinine. Except for two investigations, there was a drop in urine and serum NGAL after surgical surgery. NGAL levels were reduced by 14% in 2 hours and by 78% in 6 months.
NGAL, which is readily available but not commonly acknowledged, has the potential to be a less intrusive, low-cost diagnostic tool for urinary tract blockages in general. It can be utilized to track therapy success and blockage recurrence or advancement. More study is needed to recognize urine biomarkers like NGAL as a potential substitute for conventional renal function monitoring tests in the setting of obstructive uropathy.