title: Urinary NGAL and KIM-1: biomarkers for assessment of acute ischemic kidney injury following nephron sparing surgery.
abstract: OBJECTIVE
  Nephron sparing surgery is considered the treatment of choice in most patients with confined renal cancer. Interrupting renal blood flow is often necessary during such surgery, which can induce significant renal injury. We explored the possibility of using urinary NGAL and KIM-1 excretion as novel biomarkers to assess the extent of acute kidney injury after nephron sparing surgery.
  
  
  METHODS
  The study group included 27 patients who underwent open nephron sparing surgery for enhancing solid renal tumors. During surgery the renal artery was clamped for between 6 and 47 minutes. Urine samples were collected before surgery, and 1, 3, 8, 24, 48 and 72 hours after renal pedicle clamp removal. Urinary levels of NGAL and KIM-1 were determined.
  
  
  RESULTS
  Renal artery clamping induced renal injury, as reflected by increased urinary NGAL and KIM-1 in all participants. These increases in urinary NGAL excretion were evident after 1 hour of renal ischemia and lasted for 72 hours. Urinary NGAL correlated with the serum creatinine increase and ischemia duration. Compared with patients without significantly increased serum creatinine, those with significantly increased serum creatinine after nephron sparing surgery had a greater increase in urinary NGAL but not in KIM-1.
  
  
  CONCLUSIONS
  Renal injury severity after nephron sparing surgery could be quantitatively assessed by measuring urinary NGAL and KIM-1.
authors.affiliation: Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Abassi
authors.forename: Amjad
authors.initials: A
authors.lastname: Shalabi
authors.forename: Rima
authors.initials: R
authors.lastname: Sohotnik
authors.forename: Omri
authors.initials: O
authors.lastname: Nativ
authors.forename: Hoda
authors.initials: H
authors.lastname: Awad
authors.forename: Bishara
authors.initials: B
authors.lastname: Bishara
authors.forename: Victor
authors.initials: V
authors.lastname: Frajewicki
authors.forename: Igor
authors.initials: I
authors.lastname: Sukhotnik
authors.forename: Abeer
authors.initials: A
authors.lastname: Abbasi
authors.forename: Ofer
authors.initials: O
authors.lastname: Nativ
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007511:Ischemia / Q000652:urine*; D007668:Kidney / Q000098:blood supply*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008562:Membrane Glycoproteins / Q000652:urine*; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D009399:Nephrons; D011518:Proto-Oncogene Proteins / Q000652:urine*; D011991:Receptors, Virus
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus