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Clinical Trial
. 2015 Jul 22;10(7):e0133675.
doi: 10.1371/journal.pone.0133675. eCollection 2015.

Accuracy of Urinary Neutrophil Gelatinase-Associated Lipocalin in Quantifying Acute Kidney Injury after Partial Nephrectomy in Patients with Normal Contralateral Kidney

Kyo Chul Koo  1 , Jung Hwa Hong  2 , Hye Sun Lee  2 , Seong Uk Jeh  1 , Young Deuk Choi  1 , Koon Ho Rha  1 , Won Sik Ham  1
Affiliations
Clinical Trial

Accuracy of Urinary Neutrophil Gelatinase-Associated Lipocalin in Quantifying Acute Kidney Injury after Partial Nephrectomy in Patients with Normal Contralateral Kidney

Kyo Chul Koo et al. PLoS One. .

Abstract

Background: To evaluate the efficacy of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for predicting the degree of acute kidney injury (AKI) in patients following partial nephrectomy (PN).

Methods: This prospective study included 176 patients who underwent open or laparoscopic PN for solid renal tumors between June 2013 and May 2014. Urine samples were collected preoperatively and at 3, 24, and 48 h after renal pedicle clamp removal. Changes in uNGAL levels were analyzed for all patients and between subgroups that were dichotomized based on preoperative eGFR values of <60 and ≥60 mL/min/1.73m2, open and laparoscopic surgery, and according to the onset of AKI. Linear mixed models were used to investigate preoperative and perioperative features associated with postoperative uNGAL and eGFR changes at 6 months postoperatively.

Results: Among 146 patients included in the final analysis, 10 (6.8%) patients had preoperative eGFR <60 mL/min/1.73m2. In the overall group, uNGAL levels increased following PN. However, all subgroups demonstrated comparable changes in uNGAL levels over time. Multivariate analyses failed to reveal any correctable clinical features associated with postoperative uNGAL changes, whereas preoperative serum creatinine levels and the onset of AKI correlated with eGFR at 6 months postoperatively.

Conclusions: uNGAL levels may increase following PN. However, it does not appear to be a useful marker for quantifying the degree of AKI or predicting postoperative renal function in patients with normal contralateral kidney and relatively good preoperative renal function. Further analysis is necessary to assess the usefulness of uNGAL in patients with poor preoperative renal function.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Levels of (A) uNGAL and (B) normalized uNGAL, shown by time periods in the overall group following partial nephrectomy (n = 146).
Fig 2
Fig 2. Levels of uNGAL (A, B, and C) and normalized uNGAL (D, E, and F) shown by time periods between subgroups following partial nephrectomy.
See this image and copyright information in PMC

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