Background: Acute kidney injury (AKI) develops in 10% of patients after surgical abdominal aortic aneurysm (AAA) repair. Neutrophil gelatinase-associated lipocalin (NGAL) is a predictor of AKI and Endothelial Progenitor Cells (EPCs) represent a potential repair mechanism for vascular lesions. We evaluated the diagnostic power of serum (s) and urine (u) NGAL in detecting a possible event of AKI in patients undergoing surgical treatment for AAA repair. We also investigated the influence of vascular injury on EPCs.
Methods: We examined 50 patients who underwent open AAA repair. Blood and urine was collected preoperatively and every hour after surgery until 8 h to quantify sNGAL, uNGAL and circulating EPCs. AKI, was defined as a 25% decrease in eGFR compared with baseline values.
Results: There was an inverse correlation between eGFR, sNGAL and uNGAL, while a direct correlation between sNGAL APACHE II Score and EPCs was found. At receiver operating characteristic (ROC) analysis, sNGAL and uNGAL showed a very good diagnostic profile. Kaplan Meier curves showed that NGAL is a highly sensitive predictor of incidence of AKI. Univariate followed by multivariate Cox proportional hazard regression analysis showed that uNGAL and sNGAL predicted AKI independently of other potential confounders, including eGFR and APACHE II Score. Patients had at baseline and after surgical stress a significantly higher number of EPCs than control group.
Conclusions: NGAL represents an independent renal predictor of incidence of AKI. EPCs reflect the degree of vascular damage and could be considered as an indicator of disease with a reparative-regenerative vascular-endothelial function.
Keywords: Acute renal injury, aortic aneurysm repair, critical care, early biomarkers, endothelial progenitor cells, neutrophil gelatinase-associated lipocalin.
Gauzoma in A Scleroderma Patient Following Open Heart Surgery: A Case Report
Current Rheumatology Reviews Endovascular Repair of Thoracic Aortic Aneurysms
Recent Patents on Cardiovascular Drug Discovery (Discontinued) Preoperative and Follow up Multi-Detector Row CT Angiography (MDCTA) in the Evaluation of Interrupted Aortic Arch (IAA)
Current Medical Imaging An Update on the Role of the Quality of LDL in Cardiovascular Risk:The Contribution of the Universities of Palermo and Zurich
Recent Patents on Cardiovascular Drug Discovery (Discontinued) The Rationale for Comparative Studies of Accelerated Atherosclerosis in Rheumatic Diseases
Current Vascular Pharmacology Prevention of Intracerebral Haemorrhage
Current Drug Targets Medical Therapy of Aortic Aneurysms: A Pathophysiology-Based Approach
Current Vascular Pharmacology Problems and Perspectives of Abdominal Aortic Aneurysm Research
Current Drug Targets The Role of Endothelial Dysfunction in Aortic Aneurysms
Current Pharmaceutical Design Assessment of Vascular Geometry for Bilateral Carotid Artery Ligation to Induce Early Basilar Terminus Aneurysmal Remodeling in Rats
Current Neurovascular Research Anaerobic Bacteria as a Cause of Mycotic Aneurysm of the Aorta: Microbiology and Antimicrobial Therapy
Current Cardiology Reviews Arterial Dilatation-Related Diseases: The Prerequisite Condition of Arterial Elastic Tissue Damage and Endovascular Treatment
Recent Patents on Medical Imaging (Discontinued) 9.4T Magnetic Resonance Imaging of the Mouse Circle of Willis Enables Serial Characterization of Flow-Induced Vascular Remodeling by Computational Fluid Dynamics
Current Neurovascular Research Protective Role of Diabetes Mellitus on Abdominal Aortic Aneurysm Pathogenesis: Myth or Reality?
Current Vascular Pharmacology Current Therapeutic Drugs Against Cerebral Vasospasm after Subarachnoid Hemorrhage: A Comprehensive Review of Basic and Clinical Studies
Current Drug Delivery Inflammatory Events Following Subarachnoid Hemorrhage (SAH)
Current Neuropharmacology Developments in Non-Surgical Therapies for Abdominal Aortic Aneurysm
Current Vascular Pharmacology Transforming Growth Factor β Signaling Perturbation in the Loeys-Dietz Syndrome
Current Medicinal Chemistry Ruptured Renal Artery Aneurysm: Successful Endovascular Therapy with Stent-Graft Placement
Current Medical Imaging Early Timing of Endovascular Treatment for Aneurysmal Subarachnoid Hemorrhage Achieves Improved Outcomes
Current Neurovascular Research