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Urinary neutrophil gelatinase-associated lipocalin as a biomarker to monitor renal function in patients with obstructive ureteral calculi

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Abstract

Purpose

Our study aimed to investigate the clinical significance of urinary neutrophil gelatinase-associated lipocalin (NGAL) as an effective real-time monitoring biomarker of renal function in patients with obstructive ureteral calculi presenting renal colic.

Methods

A cohort of 89 first-visit patients with renal colic caused by unilateral ureteral calculi were retrospectively reviewed. 46 of which received double-J ureteral stent placement (group 1) and the remaining 43 treated conservatively with analgesics and hydration (group 2) when diagnosed. Urinary NGAL (uNGAL) values in the baseline, 2 h and 1 day after treatments were recorded. The variation of this parameter over time and the association with patients’ characteristics were analyzed.

Results

uNGAL levels decreased as time went by for patients receiving double-J ureteral stent placement (47.23 ± 28.32 ng/mL for baseline, 40.73 ± 21.86 ng/mL for 2 h and 34.67 ± 18.00 ng/mL for 1 day after operation; p = 0.0363). Nevertheless, for those treating conservatively, the levels emerged a mild increase (50.63 ± 32.30 ng/mL, 56.00 ± 32.01 ng/mL and 60.63 ± 34.08 ng/mL, correspondingly; p = 0.3708). By analyzing the association between uNGAL variation and patients’ characteristics of group 1, operation duration showed the best correlation coefficient (Pearson r = 0.6106, r2 = 0.3728, p < 0.0001).

Conclusions

uNGAL can be used as a biomarker to monitor the renal function effectively when serum creatinine (sCr) was within normal limits. And double-J ureteral stent can be considered as a protective factor to renal function in patients with obstructive ureteral calculi presenting renal colic.

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Abbreviations

AKI:

Acute kidney injury

ANOVA:

Analysis of variance

CKD:

Chronic kidney disease

CPB:

Cardiopulmonary bypass

CT:

Computerized tomography

Cys-C:

Cystatin C

ESWL:

Extracorporeal shock wave lithotripsy

KIM-1:

Kidney injury molecule-1

L-FABP:

Liver-type fatty acids binding protein

NGAL:

Neutrophil gelatinase-associated lipocalin

NRS:

Numerical rating scale

ROC:

Receiver operating characteristics

sCr:

Serum creatinine

SD:

Standard deviation

sNGAL:

Serum NGAL

uNGAL:

Urinary NGAL

URL:

Ureteroscopic lithotripsy

URS:

Ureterorenoscopy

UTI:

Urinary tract infection

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Acknowledgements

The authors thank Craig R. Brooks (Vanderbilt University Medical Center), and Xinyan Li (School of Pharmacy, Shanghai Jiao Tong University) for their technical/writing assistance.

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Author notes

  1. Subo Qian and Yunteng Huang contributed equally.

Authors and Affiliations

  1. Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Subo Qian, Yunteng Huang, Ning Wang, Yu Ding, Jun Qi & Yongjiang Yu

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  1. Subo Qian
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  2. Yunteng Huang
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  4. Yu Ding
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Contributions

SQ: project development, data collection and management, data analysis, manuscript writing; YH: data collection and management, data analysis, manuscript editing, technical support; NW: data collection, data analysis; YD: data collection; JQ: project development, manuscript editing, technical support, supervision; YJY: project development, manuscript editing, technical support, supervision.

Corresponding authors

Correspondence to Jun Qi or Yongjiang Yu.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Xinhua Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Cite this article

Qian, S., Huang, Y., Wang, N. et al. Urinary neutrophil gelatinase-associated lipocalin as a biomarker to monitor renal function in patients with obstructive ureteral calculi. World J Urol 37, 1197–1204 (2019). https://doi.org/10.1007/s00345-018-2488-z

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