Applied Medical Informatics
Original Research Vol. 30, No. 2 /2012, pp: 47-56
Copyright ©2012 by the authors; Licensee SRIMA, Cluj-Napoca, Romania. 47
Accuracy of Neutrophil Gelatinase-Associated Lipocalin in
Detecting Acute Kidney Injury after Urogenital Robotic
Assisted Laparoscopic Surgery under General Anesthesia
Orsolya MIHÁLY
1,*
, Sorana D. BOLBOACĂ
2
, Rodica RĂHĂIAN
3
, Constantin
BODOLEA
4
, Cipriana CHIRA
4
, Tudor CRISTEA
4
, Ana OBLEZNIUC
4
, Zoltán A.
MIHÁLY
5
, Ioan COMAN
5
1
County Urgency Clinical Hospital Cluj, ICU and Anesthesiology II Department. Cluj Napoca 1-3
Clinicilor, 400006 Cluj Napoca, Cluj, Romania.
2
“Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Department of Medical
Informatics and Biostatistics, 6 Louis Pasteur, 400349 Cluj-Napoca, Cluj, Romania.
3
County Urgency Clinical Hospital Cluj, Immunology Department. Cluj Napoca 1-3 Clinicilor,
400006 Cluj Napoca, Cluj, Romania.
4
City Clinical Hospital Cluj, ICU and Anesthesiology Department, 11 Tabacarilor, 400139 Cluj
Napoca, Cluj, Romania.
5
City Clinical Hospital Cluj, Urology Department. 11 Tabacarilor, 400139 Cluj Napoca, Cluj,
Romania.
E-mail(s): Mihaly.Maria@umfcluj.ro; sbolboaca@umfcluj.ro; rodirahaian@yahoo.com;
bodolea@yahoo.com; ciprianachira@yahoo.com; oblezniuc_ana@yahoo.com;
mzattika@yahoo.com; jcoman@yahoo.com
* Author to whom correspondence should be addressed; Tel.: 0040-745398005
Received: 10 April 2012 / Accepted: 30 May 2012 / Published online: 13 June 2012
Abstract
The aim of this study was to demonstrate the accuracy of Neutrophil Gelatinase-Associated
Lipocalin (NGAL) in detecting Acute Kidney Injury (AKI) after urogenital robotic surgery in
general anesthesia. Methods: A prospective longitudinal observational study, which included patients
scheduled for elective robotic surgery under general anesthesia. The serum and urine NGAL at
induction, 6 hours and 12 hours were determined. Serum creatinine was measured preoperatively
and daily 4 days postoperatively. AKI was defined as the absolute growth of serum creatinine by 0.3
mg/dl over baseline within 48 hours postoperatively. Results: 24 patients were enrolled in the study.
AKI occurred in 38% of patients. Serum NGAL increased significantly at 6 hours and 12h,
compared to baseline, with a higher increase in the group of patents without AKI. There were no
significant results for urine NGAL. A link was observed between the values of serum NGAL, with
associated significance p<0.0001. The correlations between urine NGAL were not significant. The
predictive value of NGAL, analyzed by cross-tabulation, OR was 3 for baseline value and 5.33 for
the values measured at 6 hours and 12 hours, but with no statistical significance. Conclusions: The
modifications of the NGAL levels, measured at 6 hours and 12 hours from the induction of
anesthesia, were significant with more importance at 6 hours and in patients without AKI. Serum
NGAL had no predictive value for AKI, but the risk to develop AKI was 3 times higher for
baseline determination and 5 times at 6 and 12 hours.
Keywords: Acute kidney injury; Biomarker; Neutrophil gelatinase associated lipocalin; General
anesthesia; Robotics.