The Combination of Serum Cystatin C, Urinary Kidney Injury Molecule-1 and MELD plus Score Predicts Early Acute Kidney Injury after Liver Transplantation

Tudoroiu, Marian-Irinel; Constantin, Georgiana Bianca; Paslaru, Liliana; Iacob, Speranta; Gheorghe, Cristian; Popescu, Irinel; Tomescu, Dana; Gheorghe, L.

doi:10.21614/sgo-23-2-121

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…The study confirmed the high predictive value of pNGAL (AUC 0.84 at 4 h and 0.86 at 8 h after ICU admission), and the somewhat weaker value of uNGAL (0.79 right after the procedure, 0.80 at 4 h, and 0.76 at 8 h after ICU admission), while uKIM-1 and uGST failed to detect AKI. Similar results were obtained in a recent study by Tudoroiu et al [43].…”

Section: Kim-1supporting

confidence: 93%

Urinary and Serum Biomarkers for Prediction of Acute Kidney Injury in Patients Undergoing Liver Transplantation

Lewandowska

Małyszko

Matuszkiewicz‐Rowińska

2019

Ann Transplant

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Acute kidney injury (AKI) is a frequent and serious complication of orthotopic liver transplantation (OLT), with a significant impact on mortality, graft survival, and chronic kidney disease. Currently, the diagnosis of AKI is based on changes in serum creatinine, which is a late marker, usually rising when there is already significant damage to the renal parenchyma. During the last 2 decades, various biomarkers have been studied in many clinical situations, mostly after cardiac surgery, in drug-induced AKI, or in sepsis. The present article summarizes the data on those biomarkers that have been evaluated for the prediction of AKI in patients undergoing OLT.

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Section: Kim-1supporting

confidence: 93%

Urinary and Serum Biomarkers for Prediction of Acute Kidney Injury in Patients Undergoing Liver Transplantation

Lewandowska

Małyszko

Matuszkiewicz‐Rowińska

2019

Ann Transplant

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“…Cystatin C is a non-glicolized protein with small molecular weight (13.3 kDa), a hundred times bigger than creatinine. It is produced at a constant rate by all the nucleated cells, and is freely filtered by glomeruli and minimally linked to proteins, and is not reabsorbed in the systemic circulation after the filtering (30) . Furthermore, it has shown promise as a replacement for serum creatinine in estimation of glomerular filtration rate (GFR).…”

Section: Discussionmentioning

confidence: 99%

Effects of Hydrochlorothiazide on Tenofovir Disoproxil Fumarate-Induced Nephrotoxicity in Rats

G.Al-Rakhat¹,

Al-Shawi²

2019

IJPS

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Tenofovir disoproxil fumarate, a nucleotide reverse transcriptase inhibitor utilized for the treatment of hepatitis B virus and human immunodeficiency virus infections; and is now one of the most widely used antiretroviral drug. However, tenofovir disoproxil fumarate can induce nephrotoxicity, which may be attributed to the interaction between such drug and the organic anion transporters (hOAT1, and OAT3) with consequent changes in levels of some parameters that may have a role in nephrotoxicity. Thiazide diuretics have high to intermediate potency of inhibition of OAT1s and OAT3; thus, it may possess nephroprotective effects. This study was designed to investigate whether hydrochlorthiazide has nephroprotective effects on tenofovir disoproxil fumarate-induced nephrotoxicity in rats. Twenty eight healthy adult male albino rats weighing 180-200g were utilized in this study for duration of 5weeks (35 days) treatment. Rats were randomly divided into four groups (7animals each). Group I: Negative control (orally given distilled water) by gavage tube; Group II: Rats orally received 600 mg/kg/day tenofovir disoproxil fumarate by gavage tube; Group III: Rats orally administered hydrochlorothiazide alone at a dose (10 mg/kg/day) by gavage tube, and Group IV: Rats orally administered hydrochlorothiazide at a dose (10 mg/kg/day) plus tenofovir disoproxil fumarate 600 mg/kg/day by gavage tube. On day 36 of the study, after euthanization of each animal by diethyl ether, 3-5ml of blood samples were collected from each rat by an intra-cardiac puncture, then centrifuged at 3000 rpm for 15 minutes to obtain serum, which was then transferred into suitable plain tubes and preserved at -20 °C; and it was utilized for the estimation of cystatin C and IL-10 level. Rats administered tenofovir disoproxil fumarate for 5 weeks (group II) produced a significant -elevation (P<0.05) in serum cystatin C level and –reduction in serum IL-10 levels compared to negative control group (group I); similarly, administration of hydrochlorothiazide alone to rats (group III) produced a significant -elevation (P<0.05) in serum cystatin C level and –reduction in serum IL-10 levels compared to negative control group (group I); also, rats administered combination of hydrochlorothiazide plus tenofovir disoproxil fumarate to rats for 5 weeks (group IV) produced significant elevation (P<0.05) in serum level of cystatin C, and a significant reduction (P<0.05) in IL-10 serum level in treated rats compared to the corresponding levels of negative control animals (group I); beside that in (group IV) rats there were significant reduction (P<0.05) in serum level of both cystatin C, and IL-10 in treated rats compared to the corresponding levels compared to TDF-treated (group II). In conclusion, treatment with hydrochlorthiazide plus tenofovir disoproxil fumarate in an attempt to prevent nephrotoxicity induced by tenofovir disoproxil fumarate is not attained.

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“…In O'Riordan et al study, 30-day mortality in patients with AKI who required renal dialysis was 4 times higher compared with mortality in those without renal dysfunction (5). Multiple factors can predispose to AKI after LT, such as: pre-transplant renal dysfunction, high blood pressure and pre-and post-transplant diabetes, hepatitis C infection, graft quality, severity of liver disease, nephrotoxic drugs, especially the immunosuppression, pre-LT hypoalbuminemia, duration of the intraoperative vascular clamping, cold ischemia time, intraoperative transfusion requirement, perioperative hypotension and vasopressor support need, duration of surgery (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Unlike other diseases, where new markers were discovered and used for diagnosis and staging, sCr remained the most common test in evaluating renal function.…”

Section: Introduction Introductionmentioning

confidence: 99%

The Serum Neutrophil Gelatinase-Associated Lipocalin Predicts Early Acute Kidney Injury after Liver Transplantation

Tudoroiu¹,

Constantin²,

Paslaru³

et al. 2019

SGO

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Introduction: Acute kidney injury (AKI) following liver transplantation (LT) is a frequent complication and is associated with increased morbidity and mortality. Aim: To investigate whether the levels of serum NGAL are able to predict early occurrence (within the first 48 hours) of the post-LT renal dysfunction. Methods: The study was conducted on 50 recipients transplanted at the Fundeni Clinical Institute between May 2016 and June 2017. Serum NGAL and serum creatinine (sCr) were analyzed before LT, as well as 4 and 24 hours after graft reperfusion. In defining renal failure, the criteria of Kidney Disease Improving Global Outcome (KDIGO) were used. All patients received the same renal sparing regimen of immunosuppression. Results: Twenty-four patients (48%) had early post-LT (<48 hours) renal dysfunction according to the KDIGO criteria. In the AKI group, there was a considerable increase in NGAL values at 4 hours after hepatic reperfusion in comparison with baseline values (p<0.0001), whereas in the group without AKI, the values of NGAL remained about the same (p=0.18). The single independent risk factor for early post-LT AKI occurrence was serum NGAL value 4 hours after hepatic reperfusion. The clinical utility of serum NGAL at 4 h after hepatic reperfusion for AKI prediction was excellent (AUROC 0.981, p=0.0001). Patients receiving a liver with a longer cold ischemia time (>6h) had a significantly higher NGAL serum levels at both 4 and 24h after reperfusion. Conclusion: Early renal dysfunction following LT is frequent (48%) despite using a renal sparing immunosuppression regimen. Serum NGAL at 4 hours after hepatic reperfusion accurately predict AKI early, in the first 48 hours after LT.

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The Combination of Serum Cystatin C, Urinary Kidney Injury Molecule-1 and MELD plus Score Predicts Early Acute Kidney Injury after Liver Transplantation

Cited by 6 publications

References 28 publications

Urinary and Serum Biomarkers for Prediction of Acute Kidney Injury in Patients Undergoing Liver Transplantation

Urinary and Serum Biomarkers for Prediction of Acute Kidney Injury in Patients Undergoing Liver Transplantation

Effects of Hydrochlorothiazide on Tenofovir Disoproxil Fumarate-Induced Nephrotoxicity in Rats

The Serum Neutrophil Gelatinase-Associated Lipocalin Predicts Early Acute Kidney Injury after Liver Transplantation

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