イノウエ　ソウイチロウ   INOUE SOICHIRO
  井上莊一郎
   所属   医学部医学科 麻酔学
   職種   主任教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Clinical Utility of Urinary Biomarkers for Prediction of Acute Kidney Injury and Chronic Renal Dysfunction After Open Abdominal Aortic Aneurysm Repair
掲載誌名 正式名：International Journal of Nephrology and Renovascular Disease
略　 称：Int J Nephrol Renovasc Dis.
ISSNコード：34557017
掲載区分国外
出版社名 Dove Medical Press
巻・号・頁 14,371-384頁
著者・共著者 Yumi Obata, Atsuko Kamijo-Ikemori, Soichiro Inoue
担当区分 最終著者
発行年月 2021/09
概要 Purpose: We examined the clinical utility of perioperative monitoring of urinary liver-type fatty acid binding protein (L-FABP), neutrophil gelatinase-associated lipocalin (NGAL), and albumin, for prediction of acute kidney injury (AKI) and prediction of chronic renal dysfunction in patients undergoing open surgical repair (OSR) of an abdominal aortic aneurysm.
Patients and Methods: Urine and serum samples were obtained perioperatively from 64 such patients (n=64). Patients in whom OSR-related AKI (defined by the Kidney Disease Improving Global Outcomes criteria) occurred were identified. Renal function was evaluated 3 years after OSR in patients with OSR-related AKI.
Results: The urinary biomarkers examined increased to maximum levels by 2 hours after aortic cross-clamping (AXC), regardless of whether AKI occurred. Notably, the serum creatinine (Cr) levels increased significantly immediately after OSR in patients with AKI (n=19) (vs that in patients without AKI). In patients with AKI, the increased serum Cr elevation rate, the urinary L-FABP levels 2 hours after AXC and immediately after OSR, and a reduction in eGFR documented 3 years after OSR were significantly greater in patients who underwent suprarenal AXC (n=11) than in those who underwent infrarenal AXC (n=8). Furthermore, urinary L-FABP levels 2 hours after AXC correlated significantly with the reductions in eGFR 3 years after OSR in patients with AKI.
Conclusion: Urinary L-FABP, NGAL and albumin concentrations 2 hours after AXC may be useful for early detection of OSR-related AKI. Furthermore, the increase in urinary L-FABP 2 hours after AXC may be predictive of chronic renal dysfunction in patients with OSR-related AKI.
DOI 10.2147/IJNRD.S322916.

(c)2008 St. Marianna University School of Medicine