Dynamics of Urinary Calprotectin after Renal Ischaemia |
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| Authors: | Jan Ebbing Felix S Seibert Nikolaos Pagonas Frederic Bauer Kurt Miller Carsten Kempkensteffen Karsten Günzel Alexander Bachmann Hans H Seifert Cyrill A Rentsch Peter Ardelt Christian Wetterauer Patrizia Amico Nina Babel Timm H Westhoff |
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| Institution: | 1. University Hospital Basel, Department of Urology, Basel, Switzerland;2. Charité - University Hospital, Campus Benjamin Franklin, Department of Urology, Berlin, Germany;3. University Hospital Marien Hospital Herne, Medical Department I, Ruhr University of Bochum, Bochum, Germany;4. University Hospital Basel, Department of Nephrology, Basel, Switzerland;Johannes Kepler University Linz, AUSTRIA |
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| Abstract: | Background: Urinary calprotectin has been identified as a promising biomarker for acute kidney injury. To date, however, the time-dependent changes of this parameter during acute kidney injury remain elusive. The aim of the present work was to define the time-course of urinary calprotectin secretion after ischaemia/reperfusion-induced kidney injury in comparison to neutrophil gelatinase—associated lipocalin, thereby monitoring the extent of tubular damage in nephron sparing surgery for kidney tumours. Methods: The study population consisted of 42 patients. Thirty-two patients underwent either open or endoscopic nephron sparing surgery for kidney tumours. During the surgery, the renal arterial pedicle was clamped with a median ischaemic time of 13 minutes (interquartile range, 4.5–20.3 minutes) in 26 patients. Ten retro-peritoneoscopic living donor nephrectomy patients and 6 nephron sparing surgery patients in whom the renal artery was not clamped served as controls. Urinary calprotectin and neutrophil gelatinase—associated lipocalin concentrations were repeatedly measured by enzyme-linked immunosorbent assay and assessed according to renal function parameters. Results: Urinary concentrations of calprotectin and neutrophil gelatinase—associated lipocalin increased significantly after ischaemia/reperfusion injury, whereas concentrations remained unchanged after nephron sparing surgery without ischaemia/reperfusion injury and after kidney donation. Calprotectin and neutrophil gelatinase—associated lipocalin levels were significantly increased 2 and 8 hours, respectively, post-ischaemia. Both proteins reached maximal concentrations after 48 hours, followed by a subsequent persistent decrease. Maximal neutrophil gelatinase—associated lipocalin and calprotectin concentrations were 9-fold and 69-fold higher than their respective baseline values. The glomerular filtration rate was only transiently impaired at the first post-operative day after ischaemia/reperfusion injury (p = 0.049). Conclusion: Calprotectin and neutrophil gelatinase—associated lipocalin can be used to monitor clinical and sub-clinical tubular damage after nephron sparing surgery for kidney tumours. Urinary calprotectin concentrations start rising within 2 hours after ischaemia/reperfusion-induced kidney injury. |
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