Can urinary neutrophil gelatinase-associated lipocalin have a role in the early diagnosis of acute kidney injury after coronary artery bypass graft?

Abstract

Introduction: The role of urinary neutrophil gelatinase-associated lipocalin (NGAL) as a prognostic biomarker in acute kidney injury (AKI) associated with coronary bypass graft has been suggested in some studies. However, the results have been inconclusive in different studies. Objectives: In the present research, we investigated the diagnostic and prognostic roles of NGAL in Iranian patients who developed AKI after coronary bypass surgery. Patients and Methods: This study was cross-sectional conducted on adult patients undergoing coronary artery bypass graft (CABG) surgery. Postoperative AKI was defined based on the RIFLE (risk, injury, failure, loss and end-stage kidney disease) criteria. Patients were divided into AKI and non-AKI groups. The urinary NGAL and serum creatinine levels were measured at different times after surgery. Results: Out of 29 patients, men constituted 75.9% of cases. Mean age of the patients was 61.4±7.7 years old and the mean duration of surgery was 4.9±0.6 hours. Based on serum creatinine, AKI was diagnosed in 37.9%, 17.25%, and 13.8% of patients at first, second, and third day post-surgery, respectively. The urine NGAL increased by 48.35% and 34.5% at 2 and 6 hours after surgery, respectively. However, there was no significant association between the urinary NGAL level and the incidence of post-surgery AKI. Conclusion: This study showed that urinary NGAL was inapplicable to independently diagnose or predict the outcome of transient AKI associated with CABG.

The Ability of Novel Urinary Biomarkers (NGAL and IL-18) in Predicting the in-Hospital Mortality, the Need of Renal Replacement Therapy and the Future Development of Chronic Kidney Disease in Post-Cardiac Surgery Acute Kidney Injury Patients: A New Horizon of Hope on the Anvil

“…Pezeshgi A, et al [18] in their recent study couldn't establish the ability of urinary NGAL in diagnosing AKI early and in the prediction of mortality among the observed post coronary artery bypass patients. The obvious reason for the underperformance of the novel biomarker would be the low sample size taken into consideration in their study.…”