You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology I1 Apr 2016MP58-14 NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AS A BIOMARKER OF RENAL INJURY IN PATIENTS WITH URETERIC STONES Marco Bolgeri, Khaled Farrag, Antonio Reche, Padmini Manghat, and Seshadri Sriprasad Marco BolgeriMarco Bolgeri More articles by this author , Khaled FarragKhaled Farrag More articles by this author , Antonio RecheAntonio Reche More articles by this author , Padmini ManghatPadmini Manghat More articles by this author , and Seshadri SriprasadSeshadri Sriprasad More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.812AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An accurate assessment of the risk of renal injury in the patient presenting with renal colic is challenging. Creatinine and urine output measurement have significant pitfalls in patients with normal contralateral kidneys. A biomarker of renal injury may offer the opportunity for early detection and aid clinical management. NGAL has shown good performance in the prediction of renal injury in several clinical scenarios. Our objective was to analyze the kinetics of NGAL in patients presenting with acute ureteric obstruction secondary to stone. METHODS Serum (sNGAL) and urine (uNGAL, normalized to urinary creatinine) levels were measured pre-, intra- and postoperatively in 37 subjects with acute ureteric colic, and compared with two control groups (13 patients with non-obstructive renal stones undergoing elective surgery and 10 healthy controls). Samples were analyzed with the NGAL Test (Bioporto Diagnostics, Denmark) a commercially available particle-enhanced turbidometric immunoassay. Uni- and multivariate analyses were conducted to evaluate correlation of NGAL levels with commonly adopted clinical parameters. RESULTS Levels of sNGAL decreased significantly after relief of ureteric obstruction (77ng/mL vs 82ng/mL, p=0.01), whereas uNGAL increased. uNGAL levels in the urine from the obstructed kidney were significantly higher than in the bladder (p=0.003). In patients who passed their stone, at a median 4 weeks follow-up NGAL levels were significantly lower (p=0.03). NGAL levels at presentation were significantly lower in healthy controls (p=0.003). In controls undergoing elective surgery, pre- and post-operative levels of pNGAL and uNGAL were not significantly different (p=0.61 and p=0.09) On multivariate analysis female gender and a higher white cell count were the only factors correlated with higher NGAL levels. CONCLUSIONS To our knowledge this is the first study evaluating the kinetics of NGAL at different time points in patients with obstruction due to ureteric stones. Relief of obstruction led to a significant decrease in sNGAL levels, though with a brief increase in urinary levels due to release of NGAL-rich urine from the obstructed side. Surgical intervention did not act as a confounder. These observations suggest that this biomarker could help estimating renal injury due to obstructive stones and help as a marker of de-obstruction during follow-up. Further studies are needed to establish the long-term significance of such subclinical renal injury and better define the potential role of NGAL in the clinical decision-making. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e781-e782 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Marco Bolgeri More articles by this author Khaled Farrag More articles by this author Antonio Reche More articles by this author Padmini Manghat More articles by this author Seshadri Sriprasad More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...