Urinary neutrophil gelatinase-associated lipocalin as a biomarker to monitor renal function in patients with obstructive ureteral calculi

Qian, Subo; Huang, Yunteng; Wang, Ning; Ding, Yu An; Qi, Jun; Yan, Yu

doi:10.1007/s00345-018-2488-z

Cited by 7 publications

(4 citation statements)

References 33 publications

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“…Clinical studies have demonstrated that urinary NGAL levels have high predictive value of acute kidney injury in critically ill patients, after kidney transplantation and cardiac surgery, and correlate with tubulointerstitial damage occurring in the progression of kidney disease . As far as stone disease, some authors have shown that urinary NGAL, and not KIM‐1, is a sensitive biomarker of postrenal kidney injury and useful in the clinical monitoring of patients treated with ureteral stent . Our findings are in line with these studies and suggest the idea of a possible use of urine NGAL/uCr ratio as marker of kidney disease in the specific group of PHPT patients with nephrolithiasis.…”

Section: Discussionsupporting

confidence: 88%

Investigating subtle kidney injury in primary hyperparathyroidism by means of sensitive and specific biomarkers

Cipriani

Pepe

Colangelo

et al. 2019

Clinical Endocrinology

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Objective Kidney involvement is a common complication in primary hyperparathyroidism (PHPT). No study so far has assessed the prevalence of kidney injury developing before the reduction in glomerular filtration rate (GFR) in PHPT. The study was aimed at establishing the potential role of biomarkers of kidney injury in detecting subtle renal damage in patients with PHPT. Design Cross‐sectional study. Patients A total of 69 postmenopausal patients with PHPT and 41 healthy age‐ and sex‐matched subjects were studied. Exclusion criteria were as follows: GFR < 30 mL/min, chronic inflammatory disease, nephrotic syndrome, infection, malignancy, heart failure, recent exposure to iodinated contrast media or nonsteroidal anti‐inflammatory drugs. Measurements We measured a panel of sensitive biomarkers of kidney injury in PHPT vs controls. Results Mean FGF23 and Klotho were higher in PHPT (72 ± 48 and 811 ± 366 pg/mL, respectively) than controls (53 ± 23.5 and 668.6 ± 17; P < .02 and P < .05). Urine KIM‐1/uCr was significantly higher in PHPT (1.4−6 ± 1.3−6) than controls (9.2−7 ± 7−7; P < .05); this was particularly evident in the CrCl 60‐89 mL/min category (1.36 ± 97 vs 8.2−7 ± 3.6−7; P < .02). Mean values of urine NGAL/uCr were higher in PHPT with (n = 28) compared to those without kidney stones (n = 35; 1.8−5 ± 1.4−5 and 1−5 ± 8−6; P < .0001). We found significant positive associations between urine NGAL/uCr and Ca (R = .292, P < .02) and urine KIM1/uCr and PTH (R = .329, P < .01). Conclusions We propose the utilization of these molecules, particularly urine KIM‐1/uCr and urine NGAL/uCr ratios for the assessment of subtle kidney injury in patients with PHPT. These molecules are elevated in tubular necrosis and have potential role in the development of kidney damage in PHPT, according to the severity of the disease.

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Section: Discussionsupporting

confidence: 88%

Investigating subtle kidney injury in primary hyperparathyroidism by means of sensitive and specific biomarkers

Cipriani

Pepe

Colangelo

et al. 2019

Clinical Endocrinology

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“…Qian et al [26, 37] in 2 different studies evaluated KIM-1 and NGAL values in UUO patients, respectively. In the group treated with JJ stent, KIM-1 and NGAL values significantly decreased compared to baseline on day 1, although Cr was in normal limits.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study

et al. 2021

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Introduction: Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are the leading novel biomarkers used efficiently in acute kidney injury (AKI). The levels of these biomarkers increase especially in the early period of nephrotoxic and ischemic renal damage. In this study, we aimed to investigate the clinical importance of NGAL and KIM-1 biomarkers used in the effective evaluation of kidney functions in patients with acute unilateral obstructive stone disease (AUOSD) in the management of endoscopic surgery. Materials and Methods: We prospectively included patients who underwent endoscopic surgery due to AUOSD between January 2018 and December 2019. Urine KIM-1 and NGAL values of the patients were measured preoperative period, postoperative 4th h, and postoperative 7th day. The patients were evaluated according to the location and size of the stone, the degree of renal hydronephrosis, the duration of the operation, complications, and JJ stent placement. Results: The study enrolled 50 patients. Urinary KIM-1/Cr and urinary NGAL/Cr ratios were higher in postoperative 4th h than in others (p < 0.001). Also, we found that urinary KIM-1/Cr and urinary NGAL/Cr ratios with Grade 2 and higher hydronephrosis were statistically higher than Grade 0–1 hydronephrosis (p < 0.001 and p: 0.042, respectively). Additionally, a preoperative urinary KIM-1 value of 1.24 ng/mL had a sensitivity of 78% and a specificity of 63% to predict the presence of hydronephrosis. When urine KIM-1 and NGAL results were compared with surgery time, stone size and location, serum creatinine (sCr) value, and Post-Ureteroscopic Lesion Scale grade, the difference was not statistically significant. Postoperative 7th day NGAL/Cr and KIM-1/Cr ratios were statistically higher in those with JJ stents placed (p: 0.03 and p: 0.004, respectively). Conclusion: KIM-1 and NGAL can be used in our assessment of renal function in patients with AUOSD, even if sCr is normal. Also, these biomarkers can predict the presence of hydronephrosis. It can be helpful in determining the time of surgical treatment, as well as providing information in the follow-up of patients with JJ stents after treatment.

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“…NGAL is a lipocalin located in the distal renal tubular cells and can be rapidly released after renal insults. Increases in NGAL levels predict AKI 24 to 72 hours before diagnostic sCr increases and are of prognostic value in response to renal injury [11,12]. In a meta-analysis of 2538 patients, Haase et al found that the NGAL cutoff value for predicting AKI was > 150 ng/mL [13].…”

Section: Methodsmentioning

confidence: 99%

Perioperative Anaemia is a Risk Factor of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy

Zhang

Duan

et al. 2020

Preprint

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Background Acute kidney injury (AKI) secondary to partial nephrectomy (PN) is a challenging clinical issue. During PN anaemia develops due to haemodilution and blood loss, which decreases oxygen transfer and provokes tissue hypoxia, leading to postoperative adverse outcomes. The aim of this study was to investigate the impact of perioperative anaemia on postoperative AKI after PN.Methods This retrospective cohort study included 68 adult patients undergoing PN for a single nonmetastatic renal tumor. Detailed clinical information was systematically reviewed and analyzed. Serum concentrations of neutrophil gelatinase-associated lipocalin (NGAL) and creatinine (sCr) were tested before, 2 hours and 1 day after PN surgery. Perioperative anaemia was assessed according to haematocrit (Ht) value at the same timepoint. Association between perioperative anaemia and postoperative AKI were explored by logistic regression analyses and pearson correlation analysis. Results The rate of perioperative anaemia in patients undergoing PN was 35.3% when the criteria of Ht < 30% was adopted. AKI developed in 32.4% of the patients when KDIGO criteria was applicated and in 51.5% of the patients when the criteria of serum NGAL >150 ng/mL was used. The incidence of AKI in patients with perioperative anaemia was higher than that in patients without anaemia. Univariate logistic regression analyses showed perioperative anaemia was a relevant factor of postoperative AKI in patients undergoing PN.Conclusions Perioperative anaemia might be a risk factor of postoperative AKI after PN. But the detailed interrelation still needs to be verified by large-scale prospective studies.

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Urinary neutrophil gelatinase-associated lipocalin as a biomarker to monitor renal function in patients with obstructive ureteral calculi

Cited by 7 publications

References 33 publications

Investigating subtle kidney injury in primary hyperparathyroidism by means of sensitive and specific biomarkers

Investigating subtle kidney injury in primary hyperparathyroidism by means of sensitive and specific biomarkers

Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study

Perioperative Anaemia is a Risk Factor of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy

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