title: Urinary neutrophil gelatinase-associated lipocalin in critically ill surgical cancer patients.
abstract: OBJECTIVE
  Neutrophil gelatinase-associated lipocalin (N-GAL) is an early biomarker of acute kidney injury (AKI) due to various etiologies. On the other hand, N-GAL is also elevated in patients with acute inflammatory conditions and in several solid neoplasms. The goal of this study was to assess the efficacy of N-GAL as a predictor of AKI and mortality in oncological surgical patients postoperatively in the intensive care unit (ICU).
  
  
  METHODS
  This was a prospective cohort observation study on adult cancer patients submitted to elective or emergency surgeries and admitted in the ICU. Urinary N-GAL was measured at the first 2 h after admission. AKI incidence and other complications were assessed, including hospital mortality.
  
  
  RESULTS
  A total of 22 patients were assessed (77% male, age 52.8 years, Acute Physiology and Chronic Health Evaluation II [APACHE II] 17.3) in whom the most frequent site of cancer was the gastrointestinal tract. AKI incidence was 13.6%. Urinary N-GAL was a predictor of AKI (22.0 ng/ml in patients without AKI vs. 239.1 ng/ml in patients with AKI, P < 0.001). Multivariate analysis showed that the main predictors of AKI were age, APACHE II, and N-GAL. N-GAL was also higher, although not statistically significant in patients who died in the hospital.
  
  
  CONCLUSIONS
  In oncological postoperative patients admitted to the ICU, urinary N-GAL was an independent predictor of AKI; moreover, its level was higher in the deceased patients.
authors.affiliation: General Intensive Care Unit, Cancer Hospital/Western Paraná State League for Cancer Treatment and Research (UOPECCAN), Cascavel, PR, Brazil.
authors.forename: Pericles Almeida
authors.initials: PA
authors.lastname: Delfino Duarte
authors.affiliation: General Intensive Care Unit, Cancer Hospital/Western Paraná State League for Cancer Treatment and Research (UOPECCAN), Cascavel, PR, Brazil.
authors.forename: Andreia Cristina
authors.initials: AC
authors.lastname: Fumagalli
authors.affiliation: Assis Gurgacz Medical College, Cascavel, PR, Brazil.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Wandeur
authors.affiliation: General Intensive Care Unit, Cancer Hospital/Western Paraná State League for Cancer Treatment and Research (UOPECCAN), Cascavel, PR, Brazil.
authors.forename: Delmiro
authors.initials: D
authors.lastname: Becker
keywords: Acute kidney injury; inflammation; neoplasms; postoperative