Plasma Neutrophil Gelatinase-Associated Lipocalin as an Early Diagnostic Biomarker for Acute Kidney Injury Following Cardiac Surgery

Abstract

The incidence of perioperative ARF varies according to the aetiology and definition , and type of surgery done; but for all causes, renal failure is associated with mortality rates of 60-90 %[1]. There has been a steady improvement over the last 40 years in crude mortality statistics following cardiac surgery, in the face of increasing numbers of higher risk patients[2]. This is primarily a result of improvements in cardiopulmonary bypass (CPB) technology, operative technique and postoperative management[3]. However, the incidence of acute renal failure (ARF) has not changed over this time and renal dysfunction still affects a significant number of patients in the perioperative period[4]. Plasma NGAL represents an early and reliable marker of AKI following cardiac surgery, moreover, NGAL levels correlate well with ICU stay and mortality, however, AKI is a complex disorder for which currently there is no accepted definition. Having a uniform standard for diagnosing and classifying AKI would enhance our ability to manage these patients, yet future clinical and translational research in AKI will require collaborative networks of investigators drawn from various disciplines, dissemination of information via multidisciplinary joint conferences and publications, and improved translation of knowledge from pre-clinical research.