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VOLUME 19 , ISSUE 5 ( 2015 ) > List of Articles

RESEARCH ARTICLE

Urinary neutrophil gelatinase-associated lipocalin in critically ill surgical cancer patients

Pericles Almeida Delfino Duarte, Andreia Cristina Fumagalli, Vanessa Wandeur, Delmiro Becker

Keywords : Acute kidney injury, inflammation, neoplasms, postoperative

Citation Information : Delfino Duarte PA, Fumagalli AC, Wandeur V, Becker D. Urinary neutrophil gelatinase-associated lipocalin in critically ill surgical cancer patients. Indian J Crit Care Med 2015; 19 (5):251-256.

DOI: 10.4103/0972-5229.156459

License: CC BY-ND 3.0

Published Online: 01-05-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background and Aims: Neutrophil gelatinase-associated lipocalin (N-GAL) is an early biomarker of acute kidney injury (AKI) due to various etiologies. On the other hand, N-GAL is also elevated in patients with acute inflammatory conditions and in several solid neoplasms. The goal of this study was to assess the efficacy of N-GAL as a predictor of AKI and mortality in oncological surgical patients postoperatively in the intensive care unit (ICU). Methods: This was a prospective cohort observation study on adult cancer patients submitted to elective or emergency surgeries and admitted in the ICU. Urinary N-GAL was measured at the first 2 h after admission. AKI incidence and other complications were assessed, including hospital mortality. Results: A total of 22 patients were assessed (77% male, age 52.8 years, Acute Physiology and Chronic Health Evaluation II [APACHE II] 17.3) in whom the most frequent site of cancer was the gastrointestinal tract. AKI incidence was 13.6%. Urinary N-GAL was a predictor of AKI (22.0 ng/ml in patients without AKI vs. 239.1 ng/ml in patients with AKI, P < 0.001). Multivariate analysis showed that the main predictors of AKI were age, APACHE II, and N-GAL. N-GAL was also higher, although not statistically significant in patients who died in the hospital. Conclusions: In oncological postoperative patients admitted to the ICU, urinary N-GAL was an independent predictor of AKI; moreover, its level was higher in the deceased patients.


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