Neutrophil gelatinase‐associated lipocalin as an early biomarker of acute kidney injury in liver transplantation

Jeong, Tae Dong; Kim, Sollip; Lee, Woochang; Song, Gi Won; Kim, Young‐Kug; Chun, Sail; Lee, Sung Gyu; Min, Won Ki

doi:10.1111/j.1399-0012.2012.01610.x

Cited by 26 publications

(45 citation statements)

References 26 publications

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“…Organs other than kidney, such as liver, lung, and gastrointestinal tract, also express NGAL under physiologic condition and the expression is increased under injured or post-operative condition [14]. Our previous study with critically ill patients and another study with liver transplant patients also presented the usefulness of urinary NGAL compared to plasma NGAL in the prediction of AKI or prognosis [15, 16]. Although another study performed in patients undergoing cardiac surgery presented a similar value (87 ng/mL) [11], the optimal cutoff values for detecting postoperative AKI vary across studies.…”

Section: Discussionmentioning

confidence: 99%

The incidence and risk factors of acute kidney injury after hepatobiliary surgery: a prospective observational study

Cho

Kim

et al. 2014

BMC Nephrol

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BackgroundAlthough intraperitoneal surgery is a major operation associated with postoperative acute kidney injury (AKI), the incidence, risk factors, and long-term renal outcome are not well known. We aimed to determine the risk factors and 6 months renal outcome in patients with clinical or subclinical AKI after hepatobiliary surgery. We also assessed the validity of urine neutrophil gelatinase-associated lipocalin (NGAL) in the early detection of AKI or prediction of renal outcome.MethodsThis prospective observational study enrolled patients with normal renal function who underwent hepatobiliary surgeries. Urine and serum samples were collected for NGAL measurement.ResultsAmong 131 patients, 10 (7.6%) developed postoperative AKI. Urine NGAL at 12 h postsurgery was the most predictive parameter for the diagnosis of AKI (cutoff, 92.85 ng/mL). With the cutoff value, subclinical AKI was diagnosed in 42 (32.1%) patients. Patients with clinical AKI and those with subclinical AKI were assigned to the AKI group. The AKI group had significantly higher model for end-stage liver disease and sodium (MELD-Na) score, lower albumin level, and longer hospital stay after surgery than the non-AKI group. Older age and higher MELD-Na score were independent risk factors for the development of postoperative AKI. At 6 months postsurgery, the estimated glomerular filtration rate (eGFR) in the AKI group was significantly lower than that in the non-AKI group, although the baseline eGFR was not different. In multiple linear regression analysis, the maximum urine NGAL level during 24 h postsurgery, intraoperative fluid balance, and having liver transplantation were significantly associated with a poor 6 months renal outcome.ConclusionUrine NGAL was useful in the early diagnosis of postoperative AKI as well as in predicting the 6 months renal outcome after hepatobiliary surgery. A considerable proportion of patients developed subclinical AKI, and these patients showed worse renal outcome compared with the non-AKI group.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2369-15-169) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The incidence and risk factors of acute kidney injury after hepatobiliary surgery: a prospective observational study

Cho

Kim

et al. 2014

BMC Nephrol

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“…Several studies have demonstrated the utility of early NGAL measurements for predicting the severity and clinical outcomes of AKI [11–14]. …”

Section: Introductionmentioning

confidence: 99%

Urinary Biomarkers of Acute Kidney Injury in Patients with Liver Cirrhosis

et al. 2014

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Acute kidney injury (AKI) is a common complication in cirrhotic patients. Serum creatinine is a poor biomarker for detection of renal impairment in cirrhotic patients. This study aimed to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary interleukin-18 (IL-18) as early biomarkers of acute kidney injury in cirrhotic patients. 160 patients with cirrhosis admitted to the Liver Units at Zagazig University Hospitals were classified into three groups: (I) nonascitic patients, (II) ascitic patients without renal impairment, and (III) ascitic patients with renal impairment. Patients with renal impairment were further divided into four subgroups: [A] prerenal azotemia, [B] chronic kidney disease (CKD), [C] hepatorenal syndrome (HRS), and [D] acute tubular necrosis (ATN). Significant elevation of both urinary NGAL and urinary IL-18 in cirrhotic patients with renal impairment especially in patients with ATN was observed. Urinary NGAL and urinary IL-18 have the ability to differentiate between AKI types in patients with cirrhosis. This could improve risk stratification for patients admitted to the hospital with cirrhosis, perhaps leading to early ICU admission, transplant evaluation, and prompt initiation of HRS therapy and early management of AKI.

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“…• Received for publication 16 Using univariate analyses, other retrospective studies have also confirmed that PRBC transfusion is a risk factor for ARF occurrence. 6,9 Furthermore, in a retrospective study analysing patients with normal renal function, postoperative renal dysfunction after liver transplantation was independently associated with units of PRBC transfusion by multivariate analysis.…”

Section: Sh Hong Co Park Cs Park Serum Hyperphosphataemia Predicts mentioning

confidence: 88%

Prediction of Newly Developed Acute Renal Failure using Serum Phosphorus Concentrations after Living-donor Liver Transplantation

Hong

Park

2012

J Int Med Res

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Neutrophil gelatinase‐associated lipocalin as an early biomarker of acute kidney injury in liver transplantation

Abstract: The urinary NGAL/urine creatinine ratio may be an early biomarker of AKI in adult patients undergoing LRLT.

Cited by 26 publications

References 26 publications

The incidence and risk factors of acute kidney injury after hepatobiliary surgery: a prospective observational study

The incidence and risk factors of acute kidney injury after hepatobiliary surgery: a prospective observational study

Urinary Biomarkers of Acute Kidney Injury in Patients with Liver Cirrhosis

Prediction of Newly Developed Acute Renal Failure using Serum Phosphorus Concentrations after Living-donor Liver Transplantation

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