title: Plasma Neutrophil Gelatinase-associated Lipoprotein in Living Kidney Donors.
abstract: BACKGROUND
  Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for acute kidney injury. This study was conducted to determine the clinical implications of perioperative plasma NGAL levels for renal function after living donor nephrectomy.
  
  
  METHODS
  Between July 2013 and May 2014, 112 donors underwent live donor nephrectomy at our institution. Donor plasma NGAL levels were measured perioperatively for 6 months. The relationship between perioperative plasma NGAL and recovery of renal function was analyzed. Renal function was estimated with the Modification of Diet in Renal Disease formula.
  
  
  RESULTS
  Mean preoperative NGAL was 62.1 ± 29.5 ng/mL. Plasma NGAL was most elevated 1 week postoperatively (218 ± 95.5 ng/mL), and stabilized after 1 month (122.9 ± 45.3 ng/mL). Preoperative plasma NGAL was not correlated with donor age or preoperative estimated glomerular filtration rates (eGFR), but was negatively correlated with 6-month eGFR (r = -0.458, P < .001). During the observation period, plasma NGAL at 1 week was most correlated with 6-month eGFR (r = -0.554, P < .001). An ROC curve analysis showed that age, preoperative eGFR, and 1-week postoperative plasma NGAL were highly predictive of developing of chronic kidney disease (CKD), defined as eGFR <60 mL/min/1.73 m(2), 6 months postoperatively (AUC = 0.91, P < .001). One-week postoperative plasma NGAL was also independently associated with CKD risk at 6 months (odds ratio: 1.13 for each 10 ng/mL increase, P = .013).
  
  
  CONCLUSIONS
  Plasma NGAL becomes elevated after kidney donation and can provide information about acute kidney injury during the compensatory hyperfiltration period. Donors with increased perioperative plasma NGAL require close observation because their possibility of developing CKD after donation may be greater.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y E
authors.initials: YE
authors.lastname: Yoon
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea; Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Korea.
authors.forename: Y I
authors.initials: YI
authors.lastname: Cho
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H H
authors.initials: HH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Huh
authors.affiliation: Department of Surgery, Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y S
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. Electronic address: hanwk@yuhs.ac.
authors.forename: W K
authors.initials: WK
authors.lastname: Han
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation; D000071068:Lipocalin-2 / Q000097:blood*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy; D011184:Postoperative Period; D057234:Preoperative Period; D020127:Recovery of Function
chemical_list: D015415:Biomarkers; D000071068:Lipocalin-2