title: [Intervention of NGAL and HO-1 in valve replacement surgery-induced acute kidney injury].
abstract: OBJECTIVE
  To determine the pathological mechanism and prevent heart-renal syndrome after heart valve replacement surgery.
  
  
  METHODS
  A total of 46 patients were admitted for selective valve replacement, and divide into 3 groups randomly: a control group (Con, n=16), a remote ischemic perconditioning (RIPerC) group (n=15) and a remote ischemic postconditioning (RIPostC) group (n=15). The serum creatinine (SCr), blood urea nitrogen (BUN), serum heme oxygennase-1 (HO-1), serum iron and urinary neutrophil gelatinase associated lipocalin (NGAL) level in the 3 groups were compared preoperatively and 6, 12, 24, 48 h after aortic cross-release.
  
  
  RESULTS
  Compared with the preoperative level, the SCr, BUN, urinary NGAL, serum iron (6 and 12 h) and serum HO-1 values were significantly increased after the heart valve replacement surgery in the control patients, RIPreC and RIPostC groups (P<0.05). Compared with the control group, the serum HO-1 was significantly increased at 6, 12, 24, 48 h after the heart valve replacement surgery in both the RIPerC and RIPostC groups (P<0.05); the SCr, BUN, urinary NGAL and serum iron values were decreased at 6, 12, 24, 48 h after the heart valve replacement surgery in both the RIPerC and RIPostC groups (P>0.05).
  
  
  CONCLUSIONS
  Abnormal change in urinary NGAL, serum iron and HO-1 can be used as early warning indicators of acute kidney injury when cardio-renal syndrome occurrs among patients under heart valve replacement surgery. Remote ischemic conditioning plays a preventive role in the occurrence of cardio-renal syndrome and renal protection.
authors.affiliation: Department of Nephrology, Changsha Central Hospital, Changsha 410004, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.forename: Wanjun
authors.initials: W
authors.lastname: Luo
authors.forename: Qiaoling
authors.initials: Q
authors.lastname: Zhou
mesh_terms: D058186:Acute Kidney Injury / Q000378:metabolism*; D000209:Acute-Phase Proteins / Q000378:metabolism*; D001806:Blood Urea Nitrogen; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D051547:Heme Oxygenase-1 / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000097:blood; D057775:Ischemic Postconditioning; D019194:Ischemic Preconditioning; D000071068:Lipocalin-2; D054834:Lipocalins / Q000378:metabolism*; D011518:Proto-Oncogene Proteins / Q000378:metabolism*
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine; D007501:Iron; C496541:HMOX1 protein, human; D051547:Heme Oxygenase-1