Year : 2017  |  Volume : 20  |  Issue : 3  |  Page : 297--302

Neutrophil gelatinase-associated lipocalin as a biomarker for predicting acute kidney injury during off-pump coronary artery bypass grafting


Muralidhar Kanchi1, R Manjunath2, Jos Massen3, Lloyd Vincent4, Kumar Belani5 
1 Department of Anesthesia and Intensive Care, Narayana Hrudayalaya Hospital, Bengaluru, Karnataka, India
2 Department of Anesthesia, Narayana Hrudayalaya Hospital, Bengaluru, Karnataka, India
3 Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
4 Department of Nephrology, Narayana Hrudayalaya Hospital, Bengaluru, Karnataka, India
5 Department of Anesthesiology, Medicine and Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA

Correspondence Address:
Muralidhar Kanchi
Department of Anaesthesia, and Intensive Care, Narayana Hrudayalaya Hospital, #258/A, Bommasandra Industrial Area, Anekal Taluk, Bengaluru, Karnataka
India

Background: Acute kidney injury (AKI) following cardiac surgery is a major complication resulting in increased morbidity, mortality, and economic burden. In this study, we assessed the usefulness of estimating serum neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker in predicting AKI in patients with stable chronic kidney disease (CKD) and undergoing off-pump coronary artery bypass grafting (OP-CABG). Patients and Methods: We prospectively studied sixty nondialysis-dependent CKD patients with estimated glomerular filtration rate <60 ml/min/1.73 m2 who required elective OP-CABG. Patients were randomized into two groups, Group D received dopamine infusion at 2 μg/kg/min following anesthesia induction till the end of the surgery and Group P did not receive any intervention. Serum creatinine, NGAL, brain natriuretic peptide, and troponin-I were estimated at specified intervals before, during, and after surgery. The results of the study patients were also compared to a simultaneous matched cohort control of thirty patients (Group A) without renal dysfunction who underwent OP-CABG. Results: No patient required renal replacement therapy, and no mortality was observed during perioperative and hospitalization period. Six patients from control group (n = 30), ten patients from placebo group (n = 30), and 12 patients from dopamine group (n = 30) developed stage 1 AKI. However, we did not observe any stage 2 and stage 3 AKI among all the groups. There was a significant increase in serum NGAL levels at the end of surgery and 24 h postoperatively in placebo and dopamine groups as compared to the control. Conclusion: The measurement of NGAL appears to predict the occurrence of AKI after OP-CAB surgery. However, large multicentric studies may be required to confirm the findings of this study.


How to cite this article:
Kanchi M, Manjunath R, Massen J, Vincent L, Belani K. Neutrophil gelatinase-associated lipocalin as a biomarker for predicting acute kidney injury during off-pump coronary artery bypass grafting.Ann Card Anaesth 2017;20:297-302


How to cite this URL:
Kanchi M, Manjunath R, Massen J, Vincent L, Belani K. Neutrophil gelatinase-associated lipocalin as a biomarker for predicting acute kidney injury during off-pump coronary artery bypass grafting. Ann Card Anaesth [serial online] 2017 [cited 2020 Jan 23 ];20:297-302
Available from: http://www.annals.in/article.asp?issn=0971-9784;year=2017;volume=20;issue=3;spage=297;epage=302;aulast=Kanchi;type=0