Dynamics of urinary calprotectin after renal ischaemia

  • Background: Urinary calprotectin has been identified as a promising biomarker for acute kidney injury. To date, however, the time-dependent changes of this parameter during acute kidney injury remain elusive. The aim of the present work was to define the time-course of urinary calprotectin secretion after ischaemia/reperfusion-induced kidney injury in comparison to neutrophil gelatinase-associated lipocalin, thereby monitoring the extent of tubular damage in nephron sparing surgery for kidney tumours. Methods: The study population consisted of 42 patients. Thirty-two patients underwent either open or endoscopic nephron sparing surgery for kidney tumours. During the surgery, the renal arterial pedicle was clamped with a median ischaemic time of 13 minutes (interquartile range, 4.5–20.3 minutes) in 26 patients. Ten retro-peritoneoscopic living donor nephrectomy patients and 6 nephron sparing surgery patients in whom the renal artery was not clamped served as controls. Urinary calprotectin and neutrophil gelatinase-associated lipocalin concentrations were repeatedly measured by enzyme-linked immunosorbent assay and assessed according to renal function parameters. Results: Urinary concentrations of calprotectin and neutrophil gelatinase-associated lipocalin increased significantly after ischaemia/reperfusion injury, whereas concentrations remained unchanged after nephron sparing surgery without ischaemia/reperfusion injury and after kidney donation. Calprotectin and neutrophil gelatinase-associated lipocalin levels were significantly increased 2 and 8 hours, respectively, post-ischaemia. Both proteins reached maximal concentrations after 48 hours, followed by a subsequent persistent decrease. Maximal neutrophil gelatinase-associated lipocalin and calprotectin concentrations were 9-fold and 69-fold higher than their respective baseline values. The glomerular filtration rate was only transiently impaired at the first post-operative day after ischaemia/reperfusion injury (p = 0.049). Conclusion: Calprotectin and neutrophil gelatinase-associated lipocalin can be used to monitor clinical and sub-clinical tubular damage after nephron sparing surgery for kidney tumours. Urinary calprotectin concentrations start rising within 2 hours after ischaemia/reperfusion-induced kidney injury.

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Author:Jan Ebbing, Felix Sebastian SeibertORCiDGND, Nikolaos PagonasGND, Frederic BauerGND, Kurt MillerGND, Carsten KempkensteffenGND, Karsten GünzelGND, Alexander BachmannGND, Hans H. SeifertGND, Cyrill A. RentschGND, Peter Uwe ArdeltGND, Christian WetterauerGND, Patrizia AmicoGND, Nina BabelORCiDGND, Timm WesthoffORCiDGND
URN:urn:nbn:de:hbz:294-73507
DOI:https://doi.org/10.1371/journal.pone.0146395
Parent Title (English):PLoS ONE
Publisher:Public Library of Science
Place of publication:San Francisco
Document Type:Article
Language:English
Date of Publication (online):2020/07/16
Date of first Publication:2016/01/08
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Volume:11
Issue:1, Artikel e0146395
First Page:e0146395-1
Last Page:e0146395-14
Institutes/Facilities:Marienhospital Herne, Medizinische Klinik I
Marienhospital Herne, Klinik für Altersmedizin und Frührehabilitation
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International