title: Dynamics of Urinary Calprotectin after Renal Ischaemia.
abstract: BACKGROUND
  Urinary calprotectin has been identified as a promising biomarker for acute kidney injury. To date, however, the time-dependent changes of this parameter during acute kidney injury remain elusive. The aim of the present work was to define the time-course of urinary calprotectin secretion after ischaemia/reperfusion-induced kidney injury in comparison to neutrophil gelatinase-associated lipocalin, thereby monitoring the extent of tubular damage in nephron sparing surgery for kidney tumours.
  
  
  METHODS
  The study population consisted of 42 patients. Thirty-two patients underwent either open or endoscopic nephron sparing surgery for kidney tumours. During the surgery, the renal arterial pedicle was clamped with a median ischaemic time of 13 minutes (interquartile range, 4.5-20.3 minutes) in 26 patients. Ten retro-peritoneoscopic living donor nephrectomy patients and 6 nephron sparing surgery patients in whom the renal artery was not clamped served as controls. Urinary calprotectin and neutrophil gelatinase-associated lipocalin concentrations were repeatedly measured by enzyme-linked immunosorbent assay and assessed according to renal function parameters.
  
  
  RESULTS
  Urinary concentrations of calprotectin and neutrophil gelatinase-associated lipocalin increased significantly after ischaemia/reperfusion injury, whereas concentrations remained unchanged after nephron sparing surgery without ischaemia/reperfusion injury and after kidney donation. Calprotectin and neutrophil gelatinase-associated lipocalin levels were significantly increased 2 and 8 hours, respectively, post-ischaemia. Both proteins reached maximal concentrations after 48 hours, followed by a subsequent persistent decrease. Maximal neutrophil gelatinase-associated lipocalin and calprotectin concentrations were 9-fold and 69-fold higher than their respective baseline values. The glomerular filtration rate was only transiently impaired at the first post-operative day after ischaemia/reperfusion injury (p = 0.049).
  
  
  CONCLUSIONS
  Calprotectin and neutrophil gelatinase-associated lipocalin can be used to monitor clinical and sub-clinical tubular damage after nephron sparing surgery for kidney tumours. Urinary calprotectin concentrations start rising within 2 hours after ischaemia/reperfusion-induced kidney injury.
authors.affiliation: University Hospital Basel, Department of Urology, Basel, Switzerland.|Charité - University Hospital, Campus Benjamin Franklin, Department of Urology, Berlin, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Ebbing
authors.affiliation: University Hospital Marien Hospital Herne, Medical Department I, Ruhr University of Bochum, Bochum, Germany.
authors.forename: Felix S
authors.initials: FS
authors.lastname: Seibert
authors.affiliation: University Hospital Marien Hospital Herne, Medical Department I, Ruhr University of Bochum, Bochum, Germany.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Pagonas
authors.affiliation: University Hospital Marien Hospital Herne, Medical Department I, Ruhr University of Bochum, Bochum, Germany.
authors.forename: Frederic
authors.initials: F
authors.lastname: Bauer
authors.affiliation: Charité - University Hospital, Campus Benjamin Franklin, Department of Urology, Berlin, Germany.
authors.forename: Kurt
authors.initials: K
authors.lastname: Miller
authors.affiliation: Charité - University Hospital, Campus Benjamin Franklin, Department of Urology, Berlin, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Kempkensteffen
authors.affiliation: Charité - University Hospital, Campus Benjamin Franklin, Department of Urology, Berlin, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Günzel
authors.affiliation: University Hospital Basel, Department of Urology, Basel, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Bachmann
authors.affiliation: University Hospital Basel, Department of Urology, Basel, Switzerland.
authors.forename: Hans H
authors.initials: HH
authors.lastname: Seifert
authors.affiliation: University Hospital Basel, Department of Urology, Basel, Switzerland.
authors.forename: Cyrill A
authors.initials: CA
authors.lastname: Rentsch
authors.affiliation: University Hospital Basel, Department of Urology, Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Ardelt
authors.affiliation: University Hospital Basel, Department of Urology, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Wetterauer
authors.affiliation: University Hospital Basel, Department of Nephrology, Basel, Switzerland.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Amico
authors.affiliation: University Hospital Marien Hospital Herne, Medical Department I, Ruhr University of Bochum, Bochum, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Babel
authors.affiliation: University Hospital Marien Hospital Herne, Medical Department I, Ruhr University of Bochum, Bochum, Germany.
authors.forename: Timm H
authors.initials: TH
authors.lastname: Westhoff
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000473:pathology / Q000601:surgery / Q000652:urine*; D016022:Case-Control Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery / Q000652:urine*; D016030:Kidney Transplantation; D039841:Leukocyte L1 Antigen Complex / Q000652:urine*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012077:Renal Artery / Q000601:surgery; D015427:Reperfusion Injury / Q000175:diagnosis / Q000473:pathology / Q000601:surgery / Q000652:urine*; D013997:Time Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D039841:Leukocyte L1 Antigen Complex; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins