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

Se Jun Park, Hoseok Koo, Kyoung Jin Lee, Seo Hyun Kim, Seo Young Yun, Seunghyup Kim, Dong Hee Whang, Shin Young Joo, Byungmo Lee, HoJun Chin, Sihyung Park
2017 Kosin Medical Journal  
Acute kidney injury (AKI) has multiple and various causes across the pre-, peri-and post-operative time periods. 1 Post-operative AKI occurs frequently, particularly after cardiac surgery. 2, 3 Minimal changes in serum creatinine levels following surgery are related to an increased likelihood of transfer to an intensive care unit (ICU), increased length of hospitalization and high mortality. 4 Therefore, the early detection of post-operative AKI is important. AKI was defined by abrupt (within
more » ... by abrupt (within 48 hours) increase in the serum creatinine ≥ 0.3 mg/dl from baseline; a percentage increase in the 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.
doi:10.7180/kmj.2017.32.2.212 fatcat:db2btlc7bnfw5gs67m34fnpu64