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首页> 外文期刊>Annals of clinical biochemistry. >Neutrophil gelatinase-associated lipocalin and albuminuria as predictors of acute kidney injury in patients treated with goal-directed haemodynamic therapy after major abdominal surgery
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Neutrophil gelatinase-associated lipocalin and albuminuria as predictors of acute kidney injury in patients treated with goal-directed haemodynamic therapy after major abdominal surgery

机译：中性粒细胞明胶酶相关的脂蛋白和白蛋白尿是大腹部手术后目标导向血流动力学治疗患者急性肾损伤的预测指标

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Background: Neutrophil gelatinase-associated lipocalin (NGAL) is emerging as a new biomarker for the early identification of acute kidney injury (AKI). There is also increasing evidence of an association between urinary albumin/creatinine ratio (ACR) and AKI. The primary aim of this study was to evaluate the clinical utility of these biomarkers to predict AKI in a population of perioperative patients treated with goal-directed haemodynamic therapy (GDHT). Secondary aims were to examine NGAL and ACR as sensitive biomarkers to detect the effects of GDHT and to investigate the association of these biomarkers with secondary outcomes. Methods: Urine was obtained from 109 patients admitted to a critical care unit following major abdominal surgery. Patients were treated with intravenous fluid, GDHTwith intravenous fluid or GDHTwith intravenous fluid and dopexamine. Urine was collected preoperatively, and at times 0, 8 and 24 h postoperatively and outcome monitored for 28 days. Results: There were no significant differences in NGAL or ACR concentrations between the cohorts treated with GDHT compared to standard care. However, both biomarker concentrations rose significantly in all cohorts over the time points. There were no significant differences in NGAL observed between patients who developed AKI and those who did not. However, there were significantly higher ACR preoperatively in patients who developed AKI. There were higher NGAL concentrations in patients who developed an infection and who died. Conclusions: NGAL has a poor predictive role in evaluating AKI in this clinical setting. Preoperative ACR may have a role as an AKI marker.
机译：背景：中性粒细胞明胶酶相关的脂钙蛋白（NGAL）正在成为一种新型生物标志物，可用于早期识别急性肾损伤（AKI）。越来越多的证据表明尿白蛋白/肌酐比值（ACR）与AKI之间存在关联。这项研究的主要目的是评估这些生物标记物在预测目标血流动力学治疗（GDHT）围手术期患者中预测AKI的临床效用。次要目的是检查NGAL和ACR作为敏感的生物标志物，以检测GDHT的作用，并研究这些生物标志物与次要结果的相关性。方法：从109例接受腹部大手术的重症监护病房的患者中获取尿液。患者接受静脉输液，GDHT静脉输液或GDHT静脉输液和多巴胺治疗。术前，术后0、8和24小时收集尿液，并监测结果28天。结果：与标准治疗相比，接受GDHT治疗的队列中NGAL或ACR浓度无显着差异。但是，在同一时间段内，所有队列中的两种生物标志物浓度均显着上升。发生AKI的患者与未发生AKI的患者之间，在NGAL中没有观察到显着差异。但是，发生AKI的患者术前ACR明显较高。发生感染并死亡的患者的NGAL浓度较高。结论：在这种临床情况下，NGAL在评估AKI中的预测作用较差。术前ACR可能起着AKI标志物的作用。

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