Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy.

IGFBP7 NGAL NephroCheck TIMP-2 acute kidney injury biomarkers partial nephrectomy renal cell carcinoma

Journal

Biomedicines
ISSN: 2227-9059
Titre abrégé: Biomedicines
Pays: Switzerland
ID NLM: 101691304

Informations de publication

Date de publication:
28 Mar 2023
Historique:
received: 25 02 2023
revised: 20 03 2023
accepted: 27 03 2023
medline: 16 5 2023
pubmed: 16 5 2023
entrez: 16 5 2023
Statut: epublish

Résumé

Identifying acute kidney injury (AKI) within few hours of onset is certainly helpful. However, early prediction of a long-term eGFR decline may be an even more important goal. Our aim was to identify and compare serum [creatinine, kineticGFR, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL)] and urinary (NephroCheck, NGAL, proteinuria, albuminuria, acantocytes at urinary sediment) predictors of AKI that might efficiently predict long-term GFR decline after robotic Nephron-Spearing Surgery (rNSS). Monocentric prospective observational study. Patients scheduled for rNSS for suspected localized Renal Cell Carcinoma from May 2017 to October 2017 were enrolled. Samples were collected preoperatively and postoperatively (timepoints: 4 h, 10 h, 24 h, 48 h), while kidney function was re-assessed up to 24 months. 38 patients were included; 16 (42%) developed clinical AKI. The eGFR decline at 24 months was more pronounced after postoperative AKI (-20.75 vs. -7.20, NephroCheck and kineticGFR have emerged as promising noninvasive, accurate, and early biomarkers of postoperative AKI and long-term GFR decline after rNSS. Combining NephroCheck and kineticGFR in clinical practice would allow to identify high risk of postoperative AKI and long-term GFR decline as early as 10 h after surgery.

Sections du résumé

BACKGROUND BACKGROUND
Identifying acute kidney injury (AKI) within few hours of onset is certainly helpful. However, early prediction of a long-term eGFR decline may be an even more important goal. Our aim was to identify and compare serum [creatinine, kineticGFR, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL)] and urinary (NephroCheck, NGAL, proteinuria, albuminuria, acantocytes at urinary sediment) predictors of AKI that might efficiently predict long-term GFR decline after robotic Nephron-Spearing Surgery (rNSS).
METHODS METHODS
Monocentric prospective observational study. Patients scheduled for rNSS for suspected localized Renal Cell Carcinoma from May 2017 to October 2017 were enrolled. Samples were collected preoperatively and postoperatively (timepoints: 4 h, 10 h, 24 h, 48 h), while kidney function was re-assessed up to 24 months.
RESULTS RESULTS
38 patients were included; 16 (42%) developed clinical AKI. The eGFR decline at 24 months was more pronounced after postoperative AKI (-20.75 vs. -7.20,
CONCLUSIONS CONCLUSIONS
NephroCheck and kineticGFR have emerged as promising noninvasive, accurate, and early biomarkers of postoperative AKI and long-term GFR decline after rNSS. Combining NephroCheck and kineticGFR in clinical practice would allow to identify high risk of postoperative AKI and long-term GFR decline as early as 10 h after surgery.

Identifiants

pubmed: 37189664
pii: biomedicines11041046
doi: 10.3390/biomedicines11041046
pmc: PMC10135876
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Marco Allinovi (M)

Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, 50139 Florence, Italy.

Francesco Sessa (F)

Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, 50139 Florence, Italy.

Gianluca Villa (G)

Department of Anaesthesia and Intensive Care, Careggi University Hospital, 50139 Florence, Italy.
Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, 50139 Florence, Italy.

Andrea Cocci (A)

Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, 50139 Florence, Italy.

Samantha Innocenti (S)

Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, 50139 Florence, Italy.

Maria Zanazzi (M)

Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, 50139 Florence, Italy.

Lorenzo Tofani (L)

Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, 50139 Florence, Italy.

Laura Paparella (L)

Department of Anaesthesia and Intensive Care, Careggi University Hospital, 50139 Florence, Italy.

Dritan Curi (D)

Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, 50139 Florence, Italy.

Calogero Lino Cirami (CL)

Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, 50139 Florence, Italy.

Riccardo Campi (R)

Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, 50139 Florence, Italy.

Andrea Mari (A)

Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, 50139 Florence, Italy.

Agostino Ognibene (A)

Laboratory Department, Careggi University Hospital, 50139 Florence, Italy.

Maria Lorubbio (M)

Laboratory Department, Careggi University Hospital, 50139 Florence, Italy.

Alessandra Fanelli (A)

Laboratory Department, Careggi University Hospital, 50139 Florence, Italy.

Stefano Romagnoli (S)

Department of Anaesthesia and Intensive Care, Careggi University Hospital, 50139 Florence, Italy.
Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, 50139 Florence, Italy.

Paola Romagnani (P)

Pediatric Nephrology Unit, Meyer Children's Hospital, 50139 Florence, Italy.
Excellence Centre for Research, Transfer and High Education for Development of DE NOVO Therapies (DENOTHE), University of Florence, 50139 Florence, Italy.

Andrea Minervini (A)

Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, 50139 Florence, Italy.
Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy.

Classifications MeSH