Diagnostic Test to Exclude Significant Renal Injury

A method of treating a subject, who may be at risk of developing acute renal failure (ARF), with a diagnostic or therapeutic intervention that may provoke ARF, which comprises

• (a) identifying the subject as belonging to a group of subjects who are at risk of developing ARF or belonging to a group of subjects who are not at risk of developing ARF by
• i) determining the concentration of human neutrophil gelatinase associated lipocalin (NGAL) in a plasma sample from the subject, and
• ii) identifying the subject as belonging to the group of subjects who are at risk of developing ARF where the concentration of NGAL is equal to or greater than a cutoff value and identifying the subject as belonging to the group of subjects who are not at risk of developing ARF where the concentration of NGAL is less than the cutoff value, wherein the cutoff value is a value between 150 ng/ml to 100 ng/ml;
• and
• (b1) treating the subject at risk of developing ARF by maintaining and improving blood circulation to the subject's kidneys, eliminating any urinary flow obstructions in the subject, and/or avoiding the administration of a nephrotoxic drug to the subject, where the subject is identified as belonging to the group of subjects who are at risk of developing ARF, and
• (b2) performing the diagnostic or therapeutic intervention that may provoke ARF where the subject is identified as belonging to the group of subjects who are not at risk of developing ARF.

A method of treating a subject, who may be at risk of developing acute renal failure (ARF), with a diagnostic or therapeutic intervention that may provoke ARF, which comprises

• (a) identifying the subject as belonging to a group of subjects who are at risk of developing ARF or belonging to a group of subjects who are not at risk of developing ARF by
• i) determining the concentration of human neutrophil gelatinase associated lipocalin (NGAL) in a urine sample from the subject,
• ii) identifying the subject as belonging to the group of subjects who are at risk of developing ARF where the concentration of NGAL is equal to or greater than a cutoff value and identifying the subject as belonging to the group of subjects who are not at risk of developing ARF where the concentration of NGAL is less than the cutoff value, wherein the cutoff value is a value between 100 ng/ml to 50 ng/ml;
• and
• (b1) treating the subject at risk of developing ARF by maintaining and improving blood circulation to the subject's kidneys, eliminating any urinary flow obstructions in the subject, and/or avoiding the administration of a nephrotoxic drug to the subject, where the subject is identified as belonging to the group of subjects who are at risk of developing ARF, and
• (b2) performing the diagnostic or therapeutic intervention that may provoke ARF where the subject is identified as belonging to the group of subjects who are not at risk of developing ARF.