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Prospective assessment of urinary neutrophil gelatinase-associated lipoprotein in living kidney donors: toward understanding differences between chronic kidney diseases of surgical and medical origin

Authors
 Young Eun Yoon  ;  Hyung Ho Lee  ;  Joon Chae Na  ;  Woong Kyu Han 
Citation
 BJU INTERNATIONAL, Vol.123(5) : 869-876, 2019 
Journal Title
 BJU INTERNATIONAL 
ISSN
 1464-4096 
Issue Date
2019
Keywords
donor nephrectomy ; neutrophil gelatinase-associated lipoprotein ; renal function
Abstract
OBJECTIVES: To evaluate the clinical implications of postoperative urinary neutrophil gelatinase-associated lipoprotein (NGAL) changes and the association between urinary NGAL (uNGAL) and renal function in living kidney donors. SUBJECTS, PATIENTS AND METHODS: We included 76 healthy adults who underwent donor nephrectomy between December 2013 and November 2014. Perioperative serum creatinine (sCr), uNGAL, serum NGAL (sNGAL), and urinary microalbumin were prospectively measured until 6 months postoperatively. Patients with chronic kidney disease (CKD) due to medical disorders who visited our outpatient clinic during the same period were included for comparison. RESULTS: The mean (SD) preoperative uNGAL of donors was 5 (5.17) ng/mL. uNGAL (corrected for urinary creatinine) was maximal at 1-2 days postoperatively, decreased on postoperative day 3, and stabilised by 7 days after surgery. Postoperative uNGAL was not associated with sex, age, or preoperative renal function. When corrected for sNGAL to compensate for the systemic increase in NGAL with major surgery, uNGAL on days 1-3 postoperatively was negatively correlated with sCr. Postoperatively, donor uNGAL remained higher than preoperatively for up to 6 months but was significantly lower than in patients with medical CKD with similar glomerular filtration rates. CONCLUSION: Acute kidney injury due to hyperfiltration of remnant kidney after donor nephrectomy was maximal within 1-2 days postoperatively. The rise in uNGAL during this period in donors was negatively correlated with postoperative sCr levels. Decreased renal function after nephrectomy differs from that of medical CKD.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/bju.14592
DOI
10.1111/bju.14592
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Na, Joon Chae(나준채) ORCID logo https://orcid.org/0000-0003-4449-8472
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170048
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