Investigation of urinary neutrophil gelatinase associated lipocalin (NGAL) for early diagnosis of acute kidney injury after percutaneous nephrolithotomy

Abstract

Introduction: Percutaneous nephrolithotomy (PCNL) could be mentioned as the most important treatment of choice for kidney staghorn stones. Previous publications reported that the novel biomarker urinary neutrophil gelatinase-associated lipocalin (NGAL) activity significantly increases in acute kidney injury (AKI) but there is not many published articles related to increase of NGAL after PCNL procedure. Objective: This study aimed to investigate AKI by urinary measurement of NGAL after PCNL procedure. Subjects and methods: Based on a cross-sectional design, 41 patients with staghorn renal stones were nominated. All patients have been informed and signed the consent form. NGAL levels were measured by urinary sampling at 2 h before and 12 h after the procedure. Serum creatinines (Cr) were measured 12 h before and 48 h after the surgery. Demographic and clinical data including surgical procedure were recorded in Excel and analyzed by SPSS (SPSS Inc., Chicago, IL) for windows. Results: With a minimum of 20 and a maximum of 70, the mean age of patients was 47 years old. 71 of patients studied were males. There was a significant change in mean serum Cr (1.06 versus 1.12 mg/dL; p < 0.01) before and after the procedure respectively. Glomerular filtration rate (GFR) with a mean of 81.93 umol/L before the procedure was decreased (p < 0.02) to 77.46 umol/L after the procedure. The changes in urine level of NGAL were significant (p < 0.02), associated to an increase in mean value of 20.63 ng/mL (two hours before) versus 56.28 ng/mL (twelve hours after) the PCNL procedure. Conclusions: Within different extents after PCNL procedure there was a significant increase in the biomarker of NGAL levels. In order to reduce AKI and other post-operative complications, further studies in a large population of patients seem to be advantageous. (C) 2017 Pan African Urological Surgeons Association. Production and hosting by Elsevier B.V.