• The Journal of urology · Apr 2013

    Urinary NGAL and KIM-1: biomarkers for assessment of acute ischemic kidney injury following nephron sparing surgery.

    • Zaid Abassi, Amjad Shalabi, Rima Sohotnik, Omri Nativ, Hoda Awad, Bishara Bishara, Victor Frajewicki, Igor Sukhotnik, Abeer Abbasi, and Ofer Nativ.
    • Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Haifa, Israel.
    • J. Urol. 2013 Apr 1;189(4):1559-66.

    PurposeNephron sparing surgery is considered the treatment of choice in most patients with confined renal cancer. Interrupting renal blood flow is often necessary during such surgery, which can induce significant renal injury. We explored the possibility of using urinary NGAL and KIM-1 excretion as novel biomarkers to assess the extent of acute kidney injury after nephron sparing surgery.Materials And MethodsThe study group included 27 patients who underwent open nephron sparing surgery for enhancing solid renal tumors. During surgery the renal artery was clamped for between 6 and 47 minutes. Urine samples were collected before surgery, and 1, 3, 8, 24, 48 and 72 hours after renal pedicle clamp removal. Urinary levels of NGAL and KIM-1 were determined.ResultsRenal artery clamping induced renal injury, as reflected by increased urinary NGAL and KIM-1 in all participants. These increases in urinary NGAL excretion were evident after 1 hour of renal ischemia and lasted for 72 hours. Urinary NGAL correlated with the serum creatinine increase and ischemia duration. Compared with patients without significantly increased serum creatinine, those with significantly increased serum creatinine after nephron sparing surgery had a greater increase in urinary NGAL but not in KIM-1.ConclusionsRenal injury severity after nephron sparing surgery could be quantitatively assessed by measuring urinary NGAL and KIM-1.Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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