研究者情報

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	Quantitative and qualitative analyses of urinary L-FABP for predicting acute kidney injury after emergency laparotomy
掲載誌名	正式名：Journal of anesthesia 略　 称：J Anesth
掲載区分	国内
出版社名	Springer
巻・号・頁	Online ahead of print頁
著者・共著者	Okuda H, Obata Y, Kamijo-Ikemori A, Inoue S
担当区分	最終著者,責任著者
発行年月	2021/10
概要	Purpose: The aim of this study was to explore the clinical utility of urinary L-FABP for earlier prediction of acute kidney injury (AKI) after emergency laparotomy, and to assess the clinical utility of a point-of-care (POC) kit for urinary L-FABP. Methods: Forty-eight patients undergoing emergency laparotomy were divided into AKI and non-AKI groups by the kidney diseases: improving global outcome (KDIGO) criteria. Ten patients were included in the AKI group. Urinary L-FABP, albumin, N-acetyl-β-D-glucosaminidase (NAG), TIMP-2, IGFBP7, serum creatinine (SCr), and blood presepsin were measured perioperatively and compared between groups. Perioperative urinary L-FABP was also evaluated qualitatively using a POC kit. Results: L-FABP and albumin levels were significantly higher in the AKI group at all measurement points. NAG was significantly higher only postoperatively in the AKI group. There were no inter-group differences in [TIMP-2] × [IGFBP7] at any measuring point. The area under the receiver operating characteristic curve of urinary L-FABP was greater than 0.8 perioperatively, which was larger than that of other biomarkers throughout the study period. The correlation coefficient at 2 h after entering the operating room between quantitative and qualitative tests for urinary L-FABP was 0.714, which was the maximum. The sensitivity, specificity, and negative predictive value of the urinary L-FABP POC kit at 2 h after entry were 55.6%, 91.9%, and 89.5%, respectively. Conclusion: Quantitative L-FABP analyses is suitable for predicting postoperative AKI earlier in the perioperative period of emergency laparotomy. Conversely, the higher specificity of qualitative L-FABP analysis suggests that it may be useful for excluding the risk of AKI but its overall clinical validity should be further investigated.