Value of urine NGAL and L-FABP in early diagnosis of acute kidney injury after liver transplantation
10.3760/cma.j.issn.1001-7097.2010.11.004
- VernacularTitle:尿中性粒细胞明胶酶相关载脂蛋白和肝型脂肪酸结合蛋白对肝移植术后急性肾损伤的早期诊断价值
- Author:
Yi LI
;
Mingli ZHU
;
Jiaqi QIAN
;
Qiang XIA
;
Siyue WANG
;
Renhua LU
;
Miaolin CHE
;
Huili DAI
;
Qingwei WU
;
Zhaohui NI
;
Yucheng YAN
- Publication Type:Journal Article
- Keywords:
Renal insufficiency,acute;
Liver transplantation;
Neutrophil gelatinaseassociated lipocalin;
Liver-type fatty acid-binding proteins
- From:
Chinese Journal of Nephrology
2010;26(11):818-823
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding proteins (L-FABP) in early diagnosis of acute kidney injury (AKI) after liver transplantation. Methods During 2007-2008, 25 liver transplant recipients were recruited. Blood and urinary samples were collected before operation and at 2, 4, 6,12, 24, 48, 72, 120 h after portal vein opening, and used to determine serum creatinine (Scr), as well as urinary NGAL and L-FABP, which were normalized to urinary creatinine. According to the Acute Kidney Injury Network (AKIN) criteria of AKI, all the patients were divided into AKI and non-AKI groups. Standard statistics were used along with ROC analysis to evaluate the diagnose value of selected markers. Results There were no significant differences in clinical parameters between non-AKI (n=14) and AKI (n=11) groups. Both groups had a transient rise in Scr 2-12 hours after surgery, but the rise lasted longer in AKI patients (2-24 hours). While urinary L-FABP rose transiently in both groups 2-120 hours following surgery, urinary NGAL was only slightly elevated at 2 h in the non-AKI group, but rose and stayed high from 2 to 6 h in the AKI group.ROC analysis revealed that NGAL (cut-off 43.02, 26.97 and 17.19 ng/mgCr, AUC 0.766, 0.773 and 0.773 at 2, 4 and 6 h, respectively) was better than L-FABP (cut-off 3451.75 ng/mgCr, AUC 0.760 at 4 h). Conclusion Urinary NGAL appears to be a sensitive and specific marker of AKI in liver transplant recipients, but these data need to be validated in larger prospective studies.