Neutrophil gelatinase-associated lipocalin: primary care diagnostic technology update.

British Journal of General Practice, October 2016 541 BACKGROUND In current clinical practice, the consensus diagnosis of acute kidney injury (AKI) depends on the detection of an acute rise in serum creatinine and/or oliguria.1 Recognition of AKI in the community is important, as it is relatively common and associated with excess mortality and morbidity.1 In a primarycare-based cohort of around 61 000 patients, 7% had an episode of AKI over a 6-month period.2 However, detection is difficult on clinical grounds alone. In a populationbased study among patients retrospectively diagnosed with AKI from laboratory samples using the NHS England AKI algorithm, those who were managed at home by GPs had a higher risk of death than those admitted to hospital.3 Improving the recognition of AKI in the community is a national priority, but the optimal strategy to achieve this is unclear. This horizon scanning article explores the potential for neutrophil gelatinase-associated lipocalin (NGAL) to detect AKI and how this could translate to community settings.