Plasma neutrophil gelatinase-associated lipocalin role as a developing biomarker of acute renal failure following coronary artery bypass surgery

Introduction: Acute kidney injury (AKI) following coronary artery bypass graft (CABG) procure is related with elevated morbidity and mortality, early diagnosis of which is important for effective management of these patients. Neutrophil gelatinase-associated lipocalin (NGAL) is a secreted glycoprotein in response to inflammation. Objectives: The current study aimed to evaluate the role of serum NGAL in predicting AKI in a group of Iranian patients undergoing CABG. Patients and Methods: This study was a cross-sectional prospective study conducted on 79 patients undergoing CABG from Mousavi hospital, Zanjan, Iran. The blood samples for serum creatinine and plasma NGAL levels were collected before anesthesia induction and at 12th, 24th and 48th hour’s post-operative. The plasma NGAL level was measured using enzyme-linked immunosorbent assay method. The incidence of AKI was known by the risk-injury-failure-loss-end-stage renal disease (RIFLE) criteria. Results: In 23 cases (29%) AKI development was detected. In a 24-hour follow-up, the mean serum creatinine values did not change in patients while the mean plasma NGAL level was elevated within 12 hours post-operatively (207.2±180.8 ng/mL and 119.26±103.5 ng/mL in the AKI and non-AKI groups, respectively). The plasma NGAL level measured after CABG (with the cut-off point equal to 126.4 ng/mL) showed a sensitivity of 77% and a specificity of 81% for the prediction of AKI. In AKI group, no patient had grade 3 AKI and neither required dialysis. Conclusion: These data indicated that the plasma NGAL levels could be potentially utilized for early diagnosis of AKI in patients undergoing CABG.