Kosin Med J.  2017 Dec;32(2):212-220. 10.7180/kmj.2017.32.2.212.

Usefulness of neutrophil gelatinase-associated lipocalin(NGAL) to confirm subclinical acute kidney injury and renal prognosis in patients following surgery

• Park SJ
• Koo H
• Lee KJ
• Kim SH
• Yun SY
• Kim S
• Whang DH
• Joo SY
• Lee B
• Chin H
• Park S

• KMID: 2400264
• DOI: http://doi.org/10.7180/kmj.2017.32.2.212

Abstract

OBJECTIVES
The neutrophil gelatinase-associated lipocalin (NGAL) level following non cardiac surgery is useful for predicting acute kidney damage. However, there is insufficient conclusive evidence as to whether NGAL can be used to predict subclinical AKI following non-cardiac surgery.
METHODS
We measured serum NGAL and creatinine levels in 41 patients following non-cardiac surgery, and the increase of these variables was used to predict acute decreases in kidney function.
RESULTS
The study included a total of 41 patients. The mean age was 64.65 ± 17.09 years. The serum creatinine concentration was increased 12 hours after surgery. The mean SD serum NGAL decreased after 4hours after surgery and continued to decrease after 12 hours after surgery. The incidence of subclinical AKI determined by the 4 hour serum NGAL level was 10(24.4%), and the incidence of serum creatinine elevation was 0(0.0%). The incidence of subclinical AKI determined by the 12 hour serum NGAL level was 4(9.8%), and the incidence of subclinical AKI determined by serum creatinine was 4(9.8%). The elevation of NGAL was more rapid than the serum creatinine 4 hours after surgery.
CONCLUSIONS
We verified the usefulness of the serum NGAL level as a predictive factor for subclinical AKI after non-cardiac surgery.

Keyword

Acute kidney injury; Creatinine; NGAL; Prognostic factor; Surgery

MeSH Terms

Acute Kidney Injury*
Creatinine
Humans
Incidence
Kidney
Lipocalins
Neutrophils*
Prognosis*
Thoracic Surgery
Creatinine
Lipocalins

Figure

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  Fig. 1. Change in serum NGAL and serum creatinine after the operations with mean and standard error. (A) Serum creatinine (B) NGAL, neutrophil geletinase-associated lipocalin.

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  Fig. 2. Incidence of subclinical AKI with NGAL and AKI with serum creatinine after the OP. OP : operation; NGAL : neutrophil gelatinase-associated lipocalin; AKI : acute kidney injury; CV : coefficient of variation

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