Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Cairo, Egypt.
Department of General Surgery and Liver Transplantation, Faculty of Medicine, Cairo University, Giza, Cairo, Egypt.
Saudi J Kidney Dis Transpl. 2020 Mar-Apr;31(2):360-367. doi: 10.4103/1319-2442.284010.
Urinary biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and renalase were recently studied for their potential role in the early detection of acute kidney injury (AKI) in patients with cirrhosis. Our study was conducted on 50 patients with end-stage liver disease undergoing living donor liver transplantation. The patients were divided into two groups: Group I contained 23 patients with AKI who had undergone liver transplantation and Group II included 27 non-AKI patients who had undergone liver transplantation. Serum renalase and NGAL levels were measured by ELISA; renalase was measured on day 1, day 7, and three months after liver transplantation. NGAL was measured on day 1 postliver transplantation. There was an improvement in liver function, kidney functions, hemoglobin level, platelet count, and C- reactive protein levels in patients at three months posttransplantation when compared to day 1, day 3, and day 7 (P < 0.01). Comparison of the renalase level at day 1, day 7, and three months showed that there was a highly significant decline at three months in the AKI group compared to the non-AKI group (P < 0.01). Regarding the NGAL level at day 1, there was no significant difference between the AKI and non-AKI groups (P > 0.05). The receiver operating characteristic curve for the renalase biomarker showed a borderline significant change between the AKI and non-AKI groups at day 1 [area under the curve (AUC): 0.54, P = 0.08], day 7 (AUC: 0.605, P = 0.08), and three months (AUC: 0.605, P = 0.08). However, the NGAL biomarker level was not significantly different between the AKI and non-AKI groups. Our study suggests that renalase showed a better predictive value and a higher accuracy in identifying postliver transplantation patients with AKI than NGAL.
尿生物标志物，如中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和肾酶，最近被研究用于肝硬化患者急性肾损伤（AKI）的早期检测。我们的研究在 50 名接受活体供肝移植的终末期肝病患者中进行。患者分为两组：AKI 组 23 例，接受肝移植；非 AKI 组 27 例，接受肝移植。通过 ELISA 测量血清肾酶和 NGAL 水平；肝移植后第 1、第 7 和第 3 天测量肾酶；肝移植后第 1 天测量 NGAL。与肝移植后第 1、第 3 和第 7 天相比，患者在肝移植后第 3 个月肝功能、肾功能、血红蛋白水平、血小板计数和 C 反应蛋白水平有所改善（P < 0.01）。比较第 1、第 7 和第 3 天的肾酶水平发现，AKI 组在第 3 个月与非 AKI 组相比显著下降（P < 0.01）。关于第 1 天的 NGAL 水平，AKI 组和非 AKI 组之间没有显著差异（P > 0.05）。肾酶生物标志物的受试者工作特征曲线显示，AKI 组和非 AKI 组在第 1 天[曲线下面积（AUC）：0.54，P = 0.08]、第 7 天（AUC：0.605，P = 0.08）和第 3 个月（AUC：0.605，P = 0.08）之间存在显著变化。然而，AKI 组和非 AKI 组的 NGAL 生物标志物水平无显著差异。我们的研究表明，与 NGAL 相比，肾酶在识别肝移植后 AKI 患者方面具有更好的预测价值和更高的准确性。
