Neutrophil Gelatinase also known as Oncogene 24p3 is associated with Lipocalin, Coresh et. al(2007). NGAL is a protein that is in humans and is always associated with the genes of LCN2.Lipocalin abbreviated as LCN2 has a primary function of limiting bacteria growth by sequestrating iron. Lipocalin also acts as a biomarker when a kidney is injured, Donato et. al (2011). Lipocalin is bonded to bacterial siderophores; this is paramount to provide the body cells with immunity against bacterial infections; Lipocalin also serves as a growth factor. Kidney failure is mostly associated with secondary factors; however, other conditions such as inflammation, hypertension, hyperlipidemia, and proteinuria have also been known to cause Kidney disease.
According to Eddy & Nelson (2006), these secondary risk components are not sufficient themselves to cause Kidney failure commonly known as CKD (chronic kidney disease).It is crucial for humans to undergo laboratory testing. Laboratory testing will help determine the level of Neutrophil Gelatinase- Lipocalin, these tests are helpful in determining the intensity of kidney damage or disease, Kent et. al (2007). Recently, a study entitled Levels of Neutrophil Gelatinase-Associated Lipocalin for early kidney disease was undertaken with a primary objective of determining Kidneys injury or disease about levels of Neutrophil Gelatinase-Associated Lipocalin, Phillips (2003). This study targeted 96 patients from whom samples were taken; the results of this study are as discussed below.
2. Problem
This study aimed at finding a solution to chronic kidney disease and the role that NGAL (Neutrophil Gelatinase-Associated Lipocalin) plays towards intense kidney damage. Patients suffering from renal failure are known to have high levels of NGAL, Donato et. al (2011).
3. Significance to Nursing
The study helped to create awareness of chronic kidney disease; it also sensitized nurses of other risk factors that could lead to kidney damage apart from NGAL, Philips (2003). Such other factors are inclusive of hypertension, hyperlipidemia, inflammation and Proteinuria. With simple laboratory tests involving urine or serum samples, concentration or levels of NGAL are determined.
4. Purpose of the Study
The purpose of this study was to determine Levels of Neutrophil Gelatinase-Associated Lipocalin for early kidney disease, Donato et. al (2011).
5. 0 Objectives
The primary aim of this study was to assess the level of NGAL serum and urine. This study could be used to make predictions of kidney disease in a large number or cohort of patients with chronic kidney disease associated with various risk components, Donato et. al (2011).
6.0 Research Questions
This study seeks to provide an answer to the research question that, are Levels of Neutrophil Gelatinase-Associated Lipocalin in the urine or serum responsible for chronic kidney disease? And can these standards be used for early detection of chronic kidney disease? , Donato et. al (2011).
7. Methods of Study
In this study, 96 patients both male and female were examined who were whites from Europe but with varying levels of chronic kidney disease. These patients had been referred to the kidney outpatient clinic in one of the universities in Europe; the clinic specializes in handling patients with kidney impairment, Philips (2003).
8. Quantitative or Qualitative
This study was quantitative in nature as it involved collection and testing of a blood sample and urine from these patients. Also, the clinicians interviewed the respective patients; drug prescriptions to these patients and their history were also recorded. Other examinations such as body mass index, blood pressure, and blood glucose were also undertaken, Philips (2003), these components were all used for data analysis.
9.0 Research Design
This study adopted a survey research design, as it has been mentioned a total of 96 patients were studied, Kent .et al (2007). A survey research design involves selection of a few selected aspects of a population. The outcomes from a survey study are then used to make generalizations about the entire population.
10.0 Sample
The sample size for the study or n was 96 patients. Half of these were male, and the rest were female. Twenty-one of these also had diabetes, Philips (2003).
11.0 Procedures/results of Study
Statistical analysis undertaken involved tabulating and analyzing the data through computation of measures of central tendency.These are ( mean, mode and median) and also measures of dispersion that required the calculation of variance, standard deviation and maximum and minimum variables. Regression analysis was also used to analyze the data. The results mean age of the patients was 57 years, half of them were male, and 21 of these patients were diabetic. The average serum level was 2.83 mg/dl, and the estimated glomerular filtration was 41.8 ml/min with a volume of 1.73 m 2. The standard of serum in these patients who were studied was also higher as compared to that in healthy patients. The level of hemoglobin present in the blood was also found to be correlated to glomerular filtration rate. The primary outcome was that NGAL is a risk factor for chronic kidney disease.
12.0 Findings
After data manipulation, the study found out that (Neutrophil Gelatinase-Associated Lipocalin) NGAL is a marker or rather a risk factor or component towards developmental stages and progression of chronic kidney disease. It was also found out that estimated glomerular filtration rate (eGFR) is crucial in determining the impairment or failure of a kidney function. However, NGAL is itself responsible for chronic kidney disease.
13.0 Implications for Nursing
The implication of the findings was that chronic kidney disease has become a leading global health problem.However, with proper medical care and proper lifestyle, the risk factors can be minimized, Kent .et al (2007).
14.0 Contribution of Findings to Nursing Knowledge
This study revealed that, levels of NGAL determine the intensity of Kidney damage, however, estimated glomerular filtration also helps in indicating impairment of renal functions.
15.0 Ethical Considerations
While conducting nursing research, it is imperative not to force patients to participate in the research; they should volunteer to take part in the study at their will. Patients have to sign informed and written consent, the consent assures the patients of anonymity as their details such as names are not to be revealed but used for the purpose of the study alone. Acting contrary to this, a clinician will be acting against the medical profession and the provisions of the hypocritical oath.
16.0 Study Approval
The study had been approved by the ethics committee, prior to the signing of informed and written consent by the patients.
17.0 Patient Privacy Protection
The names of the patients who were studied were kept in secret, and their other details were not revealed, as the right of anonymity was guaranteed to the 96 patients who were studied. These patients also signed the informed and written consent.
18.0 Conclusion
NGAL provides a basis for determining or predicting the progression of the chronic renal disease. This is because there is a relation between Neutrophil Gelatinase-Associated Lipocalin and kidney disease, Donato.et al. (2011).
References
Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS.(2007). Prevalence of chronic kidney disease in the United States. JAMA 298: 2038–2047
Donato, V., Noto, A., Lacquaniti, A., Bolignano, D., Versaci, A., David, A., Spinelli, F. and Buemi, M. (2011). Levels of Neutrophil Gelatinase-Associated Lipocalin in 2 Patients With Crush Syndrome After a Mudslide. American Journal of Critical Care, 20(5), pp.405-409.
Kent DM, Jafar TH, Hayward RA, Tighiouart H, Landa M, de Jong P, de Zeeuw D, Remuzzi G, Kamper AL, Levey AS.(2007). Progression risk, urinary protein excretion, and treatment effects of angiotensin-converting enzyme inhibitors in nondiabetic kidney disease. J Am Soc Nephrol 18: 1959–1965,
Phillips AO. (2003). The role of renal proximal tubular cells in diabetic nephropathy. Curr Diab Rep 3: 491–496,
