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Neutrophil gelatinase-associated lipocalin associated with irreversibility of pre-liver transplant kidney dysfunction.

Abstract：

:Kidney outcomes in early post-liver transplantation (LT) are crucial for long-term prognosis, but difficult to predict. Among 203 adult LT patients, we studied the value of plasma neutrophil gelatinase-associated lipocalin (NGAL) measured pre-LT for predicting acute kidney injury (AKI), kidney-replacement therapy within three months, and kidney dysfunction at three months post-LT. Glomerular filtration rate (GFR) was estimated by creatinine-based and cystatin C-based equations. Highest NGAL levels were among patients on pre-LT kidney-replacement therapy, whereas NGAL exceeded 200 μg/L in only three (2%) patients with pre-LT GFR >60 mL/min. Pre-LT NGAL >260 μg/L predicted GFR <60 mL/min at three months post-LT (OR 17.8, 95% CI 2.1-153) independently of 19 other variables reflecting recipient characteristics, liver and kidney function, perioperative hemodynamic stress, and immunosuppression. Of 81 patients with pre-LT GFR <60 mL/min, 48% had GFR <60 mL/min at three months, and an NGAL level >260 μg/L predicted this outcome with 90% specificity and 46% sensitivity. NGAL failed to predict post-LT AKI or need for temporary kidney-replacement therapy. In conclusion, NGAL independently predicted irreversibility of pre-LT kidney dysfunction and could thus help in optimizing patient care and in the decision to perform combined liver-kidney transplantation. Pre-LT NGAL was not useful in patients with preserved pre-LT kidney function or in predicting post-LT AKI.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Aberg F,Lempinen M,Hollmén M,Nordin A,Mäkisalo H,Isoniemi H

doi

10.1111/ctr.12394

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

869-76

issue

8

eissn

0902-0063

issn

1399-0012

journal_volume

28

pub_type

杂志文章

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