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The evaluation of acute kidney injury due to ischemia by urinary neutrophil gelatinase-induced lipocalin (uNGAL) measurement in patients who underwent partial nephrectomy

  • Urology - Original Paper
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Abstract

Purpose

To investigate the role of urinary neutrophil gelatinase-induced lipocalin (uNGAL) measurement in the early diagnosis of acute kidney injury that may occur after intraoperative ischemia in patients undergoing partial nephrectomy (PN).

Methods

This prospective study included 86 patients who underwent open laparoscopic or robotic partial nephrectomy between May 2017 and May 2019. During the surgery, whether the patients had ischemia or not, type of vascular clamping and the ischemia time were noted. The definition of acute kidney injury (AKI) was classified according to Acute Kidney Injury Network (AKIN) criteria. Urine samples were collected preoperatively and 3 h after renal pedicle clamp removal and uNGAL was measured.

Results

AKI was recorded in 34 (39.5%) of 86 patients after PN. Of the 34 patients, 26 (76.4%) had level 1 and 8 (23.6%) had level 2 AKI. uNGAL levels increased significantly as an early reflection of AKI in patients who underwent intraoperative total or renal artery clamping (p = 0.024). There was no significant postoperative increase in uNGAL in the non-ischemic group (p = 0.163). uNGAL expression was detected well before serum creatinine increase. Patients with AKI after PN had higher uNGAL expression (p = 0.008) However, there was no correlation between the level of AKI and uNGAL expression (r = 0.201, p = 0.066).

Conclusion

Ischemic acute kidney injury after nephron-sparing surgery can be detected early by uNGAL measurement. In future studies comparing outcomes of different surgical techniques on renal functions after PN, uNGAL levels may be used.

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Authors and Affiliations

  1. Department of Urology, School of Medicine, Ibn-i Sina Hospital, Ankara University, Ankara, Turkey

    Cagri Akpinar, Eralp Kubilay, Mehmet Ilker Gokce, Evren Suer, Omer Gulpinar & Sumer Baltaci

  2. Department of Biochemistry, Ankara University, Ankara, Turkey

    Ozlem Dogan

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  1. Cagri Akpinar
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  2. Ozlem Dogan
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Contributions

CA: data collection, data analysis, and manuscript writing; OD: data collection and data analysis; EK: data collection; MIG, ES and OG: project development and manuscript writing; SB: project development, manuscript editing and supervision.

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Correspondence to Cagri Akpinar.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (approval number; 08-412-17) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Akpinar, C., Dogan, O., Kubilay, E. et al. The evaluation of acute kidney injury due to ischemia by urinary neutrophil gelatinase-induced lipocalin (uNGAL) measurement in patients who underwent partial nephrectomy. Int Urol Nephrol 53, 393–400 (2021). https://doi.org/10.1007/s11255-020-02660-2

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  • DOI: https://doi.org/10.1007/s11255-020-02660-2

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