Accuracy of Neutrophil Gelatinase-Associated Lipocalin in Detecting Acute Kidney Injury after Urogenital Robotic Assisted Laparoscopic Surgery under General Anesthesia

• Main Authors: Orsolya MIHÁLY, Sorana D. BOLBOACĂ, Rodica RĂHĂIAN, Constantin BODOLEA, Cipriana CHIRA, Tudor CRISTEA, Ana OBLEZNIUC, Zoltán A. MIHÁLY, Ioan COMAN
• Format: Article
• Language: English
• Published: Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 2012-06-01
• Series: Applied Medical Informatics
• Subjects: Acute kidney injury; Biomarker; Neutrophil gelatinase associated lipocalin; General anesthesia; Robotics.
• Online Access: http://ami.info.umfcluj.ro/index.php/AMI/article/view/380/pdf

The aim of this study was to demonstrate the accuracy of NGAL in detecting acute kidney injury (AKI) after urogenital robotic surgery in general anesthesia. Methods: A prospective longitudinal observational study, which included patients scheduled for elective robotic surgery under general anesthesia. The serum and urine NGAL at induction, 6 hours and 12 hours were determined. Serum creatinine was measured preoperatively and daily 4 days postoperatively. AKI was defined as the absolute growth of serum creatinine by 0.3 mg/dl over baseline within 48 hours postoperatively. Results: 24 patients were enrolled in the study. AKI occurred in 38% of patients. Serum NGAL increased significantly at 6 hours and 12h, compared to baseline, with a higher increase in the group of patents without AKI. There were no significant results for urine NGAL. A link was observed between the values of serum NGAL, with associated significance p<0.0001. The correlations between urine NGAL were not significant. The predictive value of NGAL, analyzed by cross-tabulation, OR was 3 for baseline value and 5.33 for the values measured at 6 hours and 12 hours, but with no statistical significance. Conclusions: The modifications of the NGAL levels, measured at 6 hours and 12 hours from the induction of anesthesia, were significant with more importance at 6 hours and in patients without AKI. Serum NGAL had no predictive value for AKI, but the risk to develop AKI was 3 times higher for baseline determination and 5 times at 6 and 12 hours.