Cagri Akpinar1, Ozlem Dogan2, Eralp Kubilay3, Mehmet Ilker Gokce3, Evren Suer3, Omer Gulpinar3, Sumer Baltaci3. 1. Department of Urology, School of Medicine, Ibn-i Sina Hospital, Ankara University, Ankara, Turkey. akpinar.cagri89@gmail.com. 2. Department of Biochemistry, Ankara University, Ankara, Turkey. 3. Department of Urology, School of Medicine, Ibn-i Sina Hospital, Ankara University, Ankara, Turkey.
Abstract
PURPOSE: To investigate the role of urinary neutrophil gelatinase-induced lipocalin (uNGAL) measurement in the early diagnosis of acute kidney injury that may occur after intraoperative ischemia in patients undergoing partial nephrectomy (PN). METHODS: This prospective study included 86 patients who underwent open laparoscopic or robotic partial nephrectomy between May 2017 and May 2019. During the surgery, whether the patients had ischemia or not, type of vascular clamping and the ischemia time were noted. The definition of acute kidney injury (AKI) was classified according to Acute Kidney Injury Network (AKIN) criteria. Urine samples were collected preoperatively and 3 h after renal pedicle clamp removal and uNGAL was measured. RESULTS: AKI was recorded in 34 (39.5%) of 86 patients after PN. Of the 34 patients, 26 (76.4%) had level 1 and 8 (23.6%) had level 2 AKI. uNGAL levels increased significantly as an early reflection of AKI in patients who underwent intraoperative total or renal artery clamping (p = 0.024). There was no significant postoperative increase in uNGAL in the non-ischemic group (p = 0.163). uNGAL expression was detected well before serum creatinine increase. Patients with AKI after PN had higher uNGAL expression (p = 0.008) However, there was no correlation between the level of AKI and uNGAL expression (r = 0.201, p = 0.066). CONCLUSION: Ischemic acute kidney injury after nephron-sparing surgery can be detected early by uNGAL measurement. In future studies comparing outcomes of different surgical techniques on renal functions after PN, uNGAL levels may be used.
PURPOSE: To investigate the role of urinary neutrophil gelatinase-induced lipocalin (uNGAL) measurement in the early diagnosis of acute kidney injury that may occur after intraoperative ischemia in patients undergoing partial nephrectomy (PN). METHODS: This prospective study included 86 patients who underwent open laparoscopic or robotic partial nephrectomy between May 2017 and May 2019. During the surgery, whether the patients had ischemia or not, type of vascular clamping and the ischemia time were noted. The definition of acute kidney injury (AKI) was classified according to Acute Kidney Injury Network (AKIN) criteria. Urine samples were collected preoperatively and 3 h after renal pedicle clamp removal and uNGAL was measured. RESULTS: AKI was recorded in 34 (39.5%) of 86 patients after PN. Of the 34 patients, 26 (76.4%) had level 1 and 8 (23.6%) had level 2 AKI. uNGAL levels increased significantly as an early reflection of AKI in patients who underwent intraoperative total or renal artery clamping (p = 0.024). There was no significant postoperative increase in uNGAL in the non-ischemic group (p = 0.163). uNGAL expression was detected well before serum creatinine increase. Patients with AKI after PN had higher uNGAL expression (p = 0.008) However, there was no correlation between the level of AKI and uNGAL expression (r = 0.201, p = 0.066). CONCLUSION:Ischemic acute kidney injury after nephron-sparing surgery can be detected early by uNGAL measurement. In future studies comparing outcomes of different surgical techniques on renal functions after PN, uNGAL levels may be used.
Authors: Dipen J Parekh; Joel M Weinberg; Barbara Ercole; Kathleen C Torkko; William Hilton; Michael Bennett; Prasad Devarajan; Manjeri A Venkatachalam Journal: J Am Soc Nephrol Date: 2013-02-14 Impact factor: 10.121
Authors: Christopher J Weight; Benjamin T Larson; Amr F Fergany; Tianming Gao; Brian R Lane; Steven C Campbell; Jihad H Kaouk; Eric A Klein; Andrew C Novick Journal: J Urol Date: 2010-02-19 Impact factor: 7.450
Authors: Brian R Lane; Paul Russo; Robert G Uzzo; Adrian V Hernandez; Stephen A Boorjian; R Houston Thompson; Amr F Fergany; Thomas E Love; Steven C Campbell Journal: J Urol Date: 2010-12-17 Impact factor: 7.450
Authors: Dinna N Cruz; Ching Yan Goh; Alberto Palazzuoli; Leo Slavin; Anna Calabrò; Claudio Ronco; Alan Maisel Journal: Heart Fail Rev Date: 2011-11 Impact factor: 4.214
Authors: Faris Abushamma; Abdulkarim Barqawi; Samah W Al-Jabi; Maha Akkawi; Mosab Maree; Sa'ed H Zyoud Journal: Cancer Manag Res Date: 2021-09-27 Impact factor: 3.989