The role of neutrophil gelatinase‑associated lipocalin in predicting acute kidney injury in patients undergoing off‑pump coronary artery bypass graft: A pilot study.
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Date
2016-04
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Abstract
Objective: Acute kidney injury (AKI) is a commonly encountered postoperative complication after cardiac
surgery especially in high risk patients. AKI though seen more commonly after conventional on pump coronary
artery bypass surgery (CCABG), is not uncommon after off pump coronary bypass surgery (OPCAB). Various
biomarkers have shown promise over last one decade as an early marker for predicting AKI postoperatively.
NGAL is one such biomarker whose concentration is increased in urine after any nephrotoxic and ischemic
insult. The objective of this study was to assess the role of urine NGAL in predicting AKI after OPCAB in
patients with increased risk of developing AKI. Design: A prospective cohort study. Setting: A clinical study
in a multi specialty hospital. Participants: Eighty patients. Materials and Methods: study was approved by
the hospital research ethics committee. 80 patients posted for OPCAB with an increased risk of developing
AKI defined as having a Cleveland Clinic Foundation Acute renal failure scoring System score of ≥6 were
included in the study. Patients with coronary angiography (CAG) within 48 hrs prior to surgery, pre-existing
AKI, preoperative renal replacement therapy (RRT) and CKD stage 5 were excluded. Urine NGAL level before
the start of surgery baseline and at 4 hrs post surgery were done. Renal function tests were assessed on
the day of surgery (4 hrs post surgery) and on the next three days. Result: Seven patients developed AKI
as defined by acute kidney infection network (AKIN) and risk injury failure loss end stage (RIFLE) criteria
for AKI. NGAL value at 4 hrs in patients who developed AKI was significantly higher than in those patients
who did not develop AKI (P < 0.05). Conclusion: urine NGAL is an early biomarker of acute kidney injury
in patients undergoing OPCAB surgeries. However, large multicentre studies may be needed to confirm it.
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Keywords
Acute kidney injury, Neutrophil gelatinase
Citation
Jain Vishal, Mehta Yatin, Gupta Abhinav, Sharma Reetesh, Raizada Arun, Trehan Naresh. The role of neutrophil gelatinase‑associated lipocalin in predicting acute kidney injury in patients undergoing off‑pump coronary artery bypass graft: A pilot study. Annals of Cardiac Anaesthesia. 2016 Apr; 19(2): 225-230.