Preoperative urinary neutrophil gelatinase-associated lipocalin and outcome in high-risk heart failure patients undergoing cardiac surgery

J Cardiothorac Vasc Anesth. 2014 Apr;28(2):323-7. doi: 10.1053/j.jvca.2013.07.007. Epub 2013 Dec 2.

Abstract

Objective: To investigate the ability of early urinary neutrophil gelatinase-associated lipocalin to predict postoperative complications in adult patients with ventricular dysfunction undergoing cardiac surgery.

Design: Prospective observational study.

Setting: Single-center study, university hospital.

Participants: Fifty-six adult high-risk cardiac surgical patients with preoperative cardiac failure.

Interventions: None.

Measurements and main results: Demographic and clinical characteristics were obtained, and neutrophil gelatinase-associated lipocalin was measured at baseline and at several time points after surgery. Patient characteristics and neutrophil gelatinase-associated lipocalin levels were related to renal and patient outcome. On multivariate analyses, preoperative urinary neutrophil gelatinase-associated lipocalin was an independent predictor of length of intensive care stay (p = 0.004) and in-hospital stay (p = 0.04), but not of acute kidney injury or renal replacement therapy and was not associated with baseline renal function.

Conclusions: In a cohort of high-risk cardiac surgery patients, preoperative urinary neutrophil gelatinase-associated lipocalin value provided prognostic information that was independent of the onset of acute kidney injury or of preoperative renal function.

Keywords: acute kidney injury; cardiac surgery; intensive care; neutrophil gelatinase-associated lipocalin.

MeSH terms

  • Acute Kidney Injury / urine
  • Acute-Phase Proteins / urine*
  • Aged
  • Aged, 80 and over
  • Biomarkers / urine
  • Cardiac Output, Low / etiology
  • Cardiac Surgical Procedures / methods*
  • Cardiotonic Agents / therapeutic use
  • Critical Care
  • Female
  • Heart Failure / surgery*
  • Heart Failure / urine*
  • Humans
  • Intra-Aortic Balloon Pumping
  • Kidney Function Tests
  • Length of Stay
  • Linear Models
  • Lipocalin-2
  • Lipocalins / urine*
  • Luminescence
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Proto-Oncogene Proteins / urine*
  • Renal Replacement Therapy
  • Risk Assessment
  • Treatment Outcome
  • Ventricular Dysfunction / surgery

Substances

  • Acute-Phase Proteins
  • Biomarkers
  • Cardiotonic Agents
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Proto-Oncogene Proteins