title: Urine NGAL as a biomarker of kidney damage after on- and off-pump coronary artery bypass graft surgery: a prospective pilot study.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a relatively frequent complication after coronary artery bypass graft surgery (CABG). We compared the off- and on-pump CABG procedures with respect to changes in renal function as reflected by levels of urine neutrophil gelatinase-associated lipocalin (UrNGAL).
  
  
  METHODS
  In a prospective design, we studied patients who underwent CABG, off- or on-pump, with respect to changes in glomerular filtration rate (GFR) and UrNGAL pre- and postoperatively. UrNGAL was measured using a chemiluminescent microparticle immunoassay. We recorded patients' demographics, past medical history, cardiac function and laboratory findings. Patients were grouped according to the CABG type.
  
  
  RESULTS
  Of 72 patients, 31 underwent off-pump and 41 on-pump CABG. The mean age was 65.7 ± 8.1 years and 81.9% were males. Groups were similar with respect to the prevalence of hypertension, diabetes, dyslipidaemia, body mass index, and smoking at entry. No patient experienced acute renal failure and there were no deaths. At both time points, the UrNGAL levels were similar in the two groups. Patients in the on-pump group showed a significant improvement in renal function 48 hours postoperatively compared to baseline (p<0.001). UrNGAL levels decreased significantly 3 hours after surgery in the on-pump group (p=0.001), while they tended to decrease in the off-pump group (p=0.057). The overall change in UrNGAL did not differ significantly between groups.
  
  
  CONCLUSIONS
  According to the UrNGAL measurements, neither of the two CABG techniques was superior in terms of their effect on postoperative renal function. Renal function significantly improved in the on-pump group while UrNGAL levels decreased after surgery in the same group.
authors: First Department of Cardiac Surgery, Hippokration General Hospital, Medical School of Athens, Athens, Greece.
authors: Georgios
authors: G
authors: Karaolanis
authors: Andreas
authors: A
authors: Katsaros
authors: Viktoria-Varvara
authors: VV
authors: Palla
authors: Sophia
authors: S
authors: Lionaki
authors: Demetrios
authors: D
authors: Moris
authors: Euridiki
authors: E
authors: Karanikola
authors: Myrsini
authors: M
authors: Kravaritou
authors: Vassilios
authors: V
authors: Drossos
authors: Themistoklis
authors: T
authors: Psarros
authors: Konstantinos
authors: K
authors: Triantafillou
authors: Nikolaos
authors: N
authors: Aleksandropoulos
authors: Georgios
authors: G
authors: Zografos
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D015415:Biomarkers / Q000652:urine; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods; D057186:Comparative Effectiveness Research; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects* / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology / Q000652:urine; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis / Q000652:urine; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012307:Risk Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins