Urinary Interleukin-18 and Urinary Neutrophil Gelatinase-associated Lipocalin Predict Acute Kidney Injury Following Pulmonary Valve Replacement Prior to Serum Creatinine

Buelow, Matthew; Dall, Aaron; Regner, Kevin R.; Weinberg, Catherine R.; Bartz, Peter J.; Sowiński, J; Rudd, Nancy A.; Katzmark, Lindsey; Tweddell, James S.; Earing, Michael G.

doi:10.1111/j.1747-0803.2012.00662.x

Cited by 23 publications

(19 citation statements)

References 33 publications

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“…In addition, defining the proper time point for sample collection is also important. Several previous studies performed in patients undergoing cardiac surgery or liver transplantation suggest that NGAL levels at 0–6 h postsurgery are meaningful for the early detection of AKI [8–11, 13, 17], whereas a study performed in patients undergoing non-cardiac major surgery showed no correlation of NGAL levels at 2 or 6 h postsurgery with the development of AKI [18]. In our study, we also observed that urine NGAL-12 h, but not NGAL-6 h, reliably predicts clinical AKI in patients undergoing hepatobiliary surgeries.…”

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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“…The optimal CRRT and renal recovery procedures are difficult to determine because of the lack of reliable biomarkers for the evaluation of renal injury during CRRT. Currently, neutrophil gelatinase-associated lipocalin (NGAL), interleukin (IL)-18, cystatin C and kidney injury molecule 1 (Kim-1) may be the most promising biomarkers (4)(5)(6)(7)(8). Several studies have established the potential clinical role of Kim-1 and NGAL as predictive biomarkers for AKI (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Effect of continuous renal replacement therapy on kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in patients with septic acute kidney injury

Shao

Fan

Yin

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Kidney injury molecule-1 (Kim-1) and neutrophil gelatinase-associated lipocalin (NGAL) have been investigated as biomarkers for acute kidney injury (AKI). However, they are seldom investigated in patients with septic AKI treated with continuous renal replacement therapy (CRRT). The aim of the present study was to investigate the therapeutic effectiveness and possible mechanisms of CRRT in septic AKI by observing the changes in Kim-1 and NGAL levels. A group of 38 patients with septic AKI was randomly divided into the conventional drug treatment group (group A) and the CRRT group (group B). All patients were treated with standard antisepsis agents, and group B was additionally submitted to CRRT for 24 h. The levels of Kim-1 and NGAL in serum, urine and the ultrafiltrate of CRRT were measured prior to and at 12, 24, and 48 h after treatment. In group A, urinary Kim-1 (uKim-1) levels at 12, 24 and 48 h were lower than prior to treatment (P<0.05), whereas urinary NGAL (uNGAL) showed no difference among the various time points (P>0.05). In group B, uKim-1 was decreased at 24 and 48 h compared with before treatment (all P<0.05), whereas uNGAL was decreased at 48 h (P<0.05). Serum Kim-1 did not change with time in groups A and B (P>0.05), whereas serum NGAL was increased after treatment in group A (P<0.05) but did not change in group B (P>0.05). Kim-1 and NGAL were not detected in the ultrafiltrate of CRRT. uKim-1 and uNGAL decreased significantly after CRRT, and therefore may be used to reflect the change of renal function during CRRT and to evaluate the therapeutic effectiveness of the method.

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“…This limits implementing any preventive strategies to avoid developing AKI because the optimal treatment window is believed to be within 24 hours after patient exposure to iodinated contrast 5 . Recent studies have shown urinary neutrophil gelatinase-associated lipocalin (uNGAL) rise much before sCr levels increased 6 . Studies have shown uNGAL can detect changes as early as 8 hours post-contrast in human 7 and as early as 4 hours post-contrast in rats 8, 9 .…”

Section: Introductionmentioning

confidence: 99%

Effect of Iodinated Contrast Medium in Diabetic Rat Kidneys as Evaluated by Blood-Oxygenation-Level–Dependent Magnetic Resonance Imaging and Urinary Neutrophil Gelatinase-Associated Lipocalin

Lü

Franklin

et al. 2015

Investigative Radiology

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Objectives To assess if streptozotocin (STZ) induced diabetic rats develop iodinated contrast induced acute kidney injury (CIAKI). The intra-renal R2* (= 1/ T2*) was evaluated continuously before-during-after contrast administration. Renal injury was confirmed by urinary neutrophil gelatinase-associated lipocalin (uNGAL) measurements. Materials and Methods Six Sprague-Dawley rats were administered STZ to induce diabetes (Group 1). R2* was measured before, during, and after administration of iodixanol. R2* readings were sampled from four renal regions: inner medulla, inner stripe of outer medulla (ISOM), outer stripe of outer medulla, and cortex. Peak R2* and initial up-slope of R2* increase following iodinated contrast were calculated. Data from 12 non-diabetic rats pre-treated with nitric oxide synthase and prostaglandin inhibitors to induce susceptibility to CIAKI (pre-treatment model) from a previous study were re-analyzed for peak R2* and initial up-slope of R2* increase following contrast. Six of these animals received saline (Group 2) and the other six received furosemide (Group 3) prior to idoxianol. Results Peak R2* and initial up-slope of R2* increase were used as BOLD response parameters. R2* in ISOM were comparable in all three groups prior to administration of furosemide. Except for the furosemide group, ISOM showed a rapid increase in R2* immediately following contrast administration. Unlike the L-NAME & indomethacin treated groups, the diabetic group showed a quick reversal of R2* towards baseline measurements after contrast administration. Urinary NGAL indicated significant increase in diabetic rats 4 hours following contrast administration. The observed trends with peak R2* and initial up-slope of R2* increase in renal ISOM were in agreement with those of uNGAL. Conclusion The STZ induced diabetic rat may be suitable for studying the effects of iodinated contrast on renal oxygenation status and may mimic human condition closer than the pre-treatment model described before. The peak R2* value and initial up-slope of R2* in ISOM appear to be effective MRI markers to predict renal injury following administration of an iodinated contrast agent.

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Urinary Interleukin-18 and Urinary Neutrophil Gelatinase-associated Lipocalin Predict Acute Kidney Injury Following Pulmonary Valve Replacement Prior to Serum Creatinine

Cited by 23 publications

References 33 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

Effect of continuous renal replacement therapy on kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in patients with septic acute kidney injury

Effect of Iodinated Contrast Medium in Diabetic Rat Kidneys as Evaluated by Blood-Oxygenation-Level–Dependent Magnetic Resonance Imaging and Urinary Neutrophil Gelatinase-Associated Lipocalin

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