title: Accuracy of Urinary Neutrophil Gelatinase-Associated Lipocalin in Quantifying Acute Kidney Injury after Partial Nephrectomy in Patients with Normal Contralateral Kidney.
abstract: BACKGROUND
  To evaluate the efficacy of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for predicting the degree of acute kidney injury (AKI) in patients following partial nephrectomy (PN).
  
  
  METHODS
  This prospective study included 176 patients who underwent open or laparoscopic PN for solid renal tumors between June 2013 and May 2014. Urine samples were collected preoperatively and at 3, 24, and 48 h after renal pedicle clamp removal. Changes in uNGAL levels were analyzed for all patients and between subgroups that were dichotomized based on preoperative eGFR values of <60 and ≥60 mL/min/1.73m2, open and laparoscopic surgery, and according to the onset of AKI. Linear mixed models were used to investigate preoperative and perioperative features associated with postoperative uNGAL and eGFR changes at 6 months postoperatively.
  
  
  RESULTS
  Among 146 patients included in the final analysis, 10 (6.8%) patients had preoperative eGFR <60 mL/min/1.73m2. In the overall group, uNGAL levels increased following PN. However, all subgroups demonstrated comparable changes in uNGAL levels over time. Multivariate analyses failed to reveal any correctable clinical features associated with postoperative uNGAL changes, whereas preoperative serum creatinine levels and the onset of AKI correlated with eGFR at 6 months postoperatively.
  
  
  CONCLUSIONS
  uNGAL levels may increase following PN. However, it does not appear to be a useful marker for quantifying the degree of AKI or predicting postoperative renal function in patients with normal contralateral kidney and relatively good preoperative renal function. Further analysis is necessary to assess the usefulness of uNGAL in patients with poor preoperative renal function.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyo Chul
authors.initials: KC
authors.lastname: Koo
authors.affiliation: Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jung Hwa
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seong Uk
authors.initials: SU
authors.lastname: Jeh
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Won Sik
authors.initials: WS
authors.lastname: Ham
mesh_terms: D058186:Acute Kidney Injury / Q000473:pathology / Q000503:physiopathology / Q000601:surgery / Q000652:urine; D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D010535:Laparoscopy; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009392:Nephrectomy; D011518:Proto-Oncogene Proteins / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins