title: Assessment of Renal Injury in Patients Undergoing Elective EVAR Using Urinary Neutrophil Gelatin-Associated Lipocalin, Interleukin 18, and Retinol-Binding Protein.
abstract: Acute kidney injury (AKI) is a recognized complication post-endovascular aneurysm repair (EVAR). Neutrophil gelatin-associated lipocalin (NGAL), interleukin 18 (IL-18), and retinol-binding protein are emerging urinary biomarkers that have shown promise in detecting subclinical and clinical renal impairment. In this study, we assessed changes in these urinary biomarkers as well as serum creatinine (SCr) in patients undergoing EVAR. Urine samples were collected prospectively at 5 time points for each recruited patient: pre-EVAR (baseline) and 6, 12, 24, and 48 hours after the procedure for serial assessment of urinary biomarkers. Serum creatinine was quantified preoperatively and at 24 and 48 hours postoperatively. Serial changes of urinary biomarkers and SCr were assessed. A significant increase in NGAL and IL-18 from baseline was observed ( P < .05), as early as 6 hours for NGAL. A significant rise in levels of NGAL and IL-18 precedes the significant rise in SCr. These findings highlight the potential of emerging urinary biomarkers in detecting early AKI following EVAR.
authors.affiliation: 1 Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Noorani
authors.affiliation: 1 Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Umar
authors.initials: U
authors.lastname: Sadat
authors.affiliation: 1 Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Rollins
authors.affiliation: 1 Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Chowdhury
authors.affiliation: 2 Department of Surgery, Changi General Hospital, Singapore, Singapore.
authors.forename: Tjun Y
authors.initials: TY
authors.lastname: Tang
authors.affiliation: 1 Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Seamus C
authors.initials: SC
authors.lastname: Harrison
authors.affiliation: 3 University Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Ammara
authors.initials: A
authors.lastname: Usman
authors.affiliation: 4 Department of Pathology, NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom.
authors.forename: Keith
authors.initials: K
authors.lastname: Burling
authors.affiliation: 4 Department of Pathology, NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom.
authors.forename: Anthony
authors.initials: A
authors.lastname: Nordon
authors.affiliation: 1 Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Boyle
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000652:urine*; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000601:surgery*; D015415:Biomarkers / Q000652:urine*; D003404:Creatinine / Q000097:blood; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000652:urine; D054834:Lipocalins / Q000652:urine*; D008297:Male; D011446:Prospective Studies; D012177:Retinol-Binding Proteins / Q000652:urine
chemical_list: D015415:Biomarkers; D020382:Interleukin-18; D054834:Lipocalins; D012177:Retinol-Binding Proteins; D003404:Creatinine
keywords: acute kidney injury; aneurysm; aorta; contrast medium; contrast-induced acute kidney injury; endovascular aortic aneurysm repair; interleukin 18; neutrophil gelatin-associated lipocalin; retinol-binding protein; serum creatinine