Comparison of urinary neutrophil glucosaminidase-associated lipocalin, cystatin C, and α1-microglobulin for early detection of acute renal injury after cardiac surgery

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Daniel HeiseMichael Quintel

Abstract

Acute renal injury is a frequent complication after cardiac surgery that necessitates additional treatment and increases mortality. To apply measures for optimizing renal function in a well-directed and effective way, it is most important to detect acute kidney injury at an early stage. The present study compares three markers of renal tubular function for detection of acute renal injury according to the acute kidney injury (Acute Kidney Injury Network (AKIN)) criteria. Urinary concentration of the tubular markers neutrophil glucosaminidase-associated lipocalin (NGAL), α1-microglobulin (α1MG), and cystatin C (CysC) were measured in 50 patients after elective cardiac surgery. Samples were taken once preoperatively and postoperatively every 12 h for up to 5 days. Based on the highest recorded postoperative AKIN score, patients were divided into two groups (AKIN 0 and AKIN 1-3). Statistical analysis was done for marker concentrations at three time points: preoperative, after admission to the intensive care unit (ICU), and at the highest postoperative AKIN level. In addition, all concentrations of marker proteins were multiplied by the ratio of creatinine concentrations in serum and urine; these products were also analyzed statisti...Continue Reading

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