The early diagnosis of acute kidney injury after liver transplantation by urine lactate dehydrogenase, cystatin C and neutrophil gelatinase-associated lipocalin

Abstract

Objective To investigate the value of urinary lactate dehydrogenase(LDH),Cystatin C (Cys-C) and neutrophil gelatinase-associated lipocalin (NGAL) in early diagnosis of acute kidney injury after liver transplantation. Methods From January 2011 to October 2011,45 patients were recruited.Blood and urinary samples were collected before operation and the end of the operation,and used to determine serum creatinine (SCr),Cys-C,LDH,and total bilirubin,as well as urinary LDH,Cys-C and NGAL.All the patients were divided into AKI and non-AKI groups,according to the Acute Kidney Injury Network (AKIN) criteria of AKI.The statistics were used along ROC analysis to evaluate the diagnose value of selected biomarkers. Results There were no significant differences in clinical parameters between AKI and non-AKI groups while 20 of the 45 patients suffered AKI [ ( 140±54)vs (81±20),P＜0.05].Urine LDH,Cys-C and NGAL raised in all the samples,and the level of the 3 enzymes in AKI group increased significantly [ (6.50±2.86)vs (3.21±1.63),P＜0.05 ],[ ( 1.55±0.54)vs (0.86±0.31),P＜0.05 ],[ ( 107±59)vs (43±11 ),P＜0.05 ].ROC analysis revealed that (AUC 0.853,0.833,0.880) the 3 enzymes are capable of early diagnosis of AKI. Conclusions Urinary LDH,Cys-C and NGAL appear to be sensitive and specific biomarkers of AKI in liver transplant recipients,but further research are needed in the future for the clinical diagnosis. Key words: Liver transplantation; Acute kidney injury ; Lactate dehydrogenase ; Cystatin C; Neutrophil gelatinaseassociated lipocalin