Neutrophil gelatinase-associated lipocalin as an early indicator for postoperative renal failure

Neutrophil gelatinase-associated lipocalin plasma (pNGAL) and urine (uNGAL) concentrations can be used as early indicators for the development of acute kidney injury (AKI) [1]. As AKI is associated with higher risk of morbidity and mortality in ICU patients [2], higher pNGAL and uNGAL on admission might be relevant to the clinical course. No data on pNGAL and uNGAL as early indicators of postoperative AKI have been published.

We collected plasma and urine samples from patients admitted postoperatively following noncardiopulmonary bypass-related surgery. NGAL concentrations were measured using an immunofluorescence assay. Subsequently we compared the time points of maximum pNGAL, uNGAL and SCr concentrations in the group of patients developing postoperative AKI (Mann-Whitney U test). Data are presented as mean ± SD.

In postoperative patients developing AKI, pNGAL and uNGAL reach peak concentrations 1 day earlier than SCr. This might be of clinical importance as it provides us with an opportunity to prevent further deterioration of renal function at an earlier stage.