The Role of Neutrophil Gelatinase-associated Lipocalin As a Predictive Biomarker of Acute Kidney Injury in Patients Undergoing Major Abdominal Surgery

Objective: The current study investigates the development of acute kidney injury (AKI) in patients undergoing major abdominal surgery via earlier determination of the rise in neutrophil gelatinase-associated lipocalin (pNGAL) compared to that in creatinine. Methods: In this prospective observational study, 60 patients aged between 18 and 65 undergoing major abdominal surgery were selected for the investigation after obtaining ethics committee approval. Patients who did not meet the age criteria, had liver and kidney failures, severe cardiac and respiratory distress, used angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs, developed postoperative respiratory failure, cardiogenic and septic shock, relapse in the 1st 24 h, and those who underwent emergency surgery were excluded from the study. Leukocyte and creatinine values (preoperatively and at 24 and 48 h postoperatively), pNGAL (at 0 h intraoperatively and 6 h and 24 h postoperatively), lactate values (at 0 h intraoperatively and 24 h and 48 h postoperatively), and urine output value (at 24 and 48 h postoperatively) were evaluated. Results: Of the 60 patients, 9 (15%) showed increased pNGAL values at 6 h postoperatively; however, increased creatinine values and decreased urine output values were observed at 48 h postoperatively. Thus, AKI development was detected at an early stage. The change in leukocyte and lactate values was not statistically significant. Conclusion: pNGAL was proven to be an early predictive biomarker of AKI in patients undergoing major abdominal surgery.