Dynamics of Urinary Calprotectin after Renal Ischaemia. Ebbing, J., Seibert, F. S., Pagonas, N., Bauer, F., Miller, K., Kempkensteffen, C., Gunzel, K., Bachmann, A., Seifert, H. H., Rentsch, C. A., Ardelt, P., Wetterauer, C., Amico, P., Babel, N., & Westhoff, T. H. PloS one, 11(1):e0146395, 2016.
doi  abstract   bibtex   
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.
@article{ebbing_dynamics_2016,
	title = {Dynamics of {Urinary} {Calprotectin} after {Renal} {Ischaemia}.},
	volume = {11},
	issn = {1932-6203 1932-6203},
	doi = {10.1371/journal.pone.0146395},
	abstract = {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.},
	language = {eng},
	number = {1},
	journal = {PloS one},
	author = {Ebbing, Jan and Seibert, Felix S. and Pagonas, Nikolaos and Bauer, Frederic and Miller, Kurt and Kempkensteffen, Carsten and Gunzel, Karsten and Bachmann, Alexander and Seifert, Hans H. and Rentsch, Cyrill A. and Ardelt, Peter and Wetterauer, Christian and Amico, Patrizia and Babel, Nina and Westhoff, Timm H.},
	year = {2016},
	pmid = {26745147},
	pmcid = {PMC4706321},
	keywords = {*Kidney Transplantation, Acute-Phase Proteins/*urine, Adult, Aged, Biomarkers/urine, Carcinoma, Renal Cell/blood supply/pathology/surgery/*urine, Case-Control Studies, Female, Glomerular Filtration Rate, Humans, Kidney Neoplasms/blood supply/pathology/surgery/*urine, Kidney/blood supply/metabolism/pathology/surgery, Leukocyte L1 Antigen Complex/*urine, Lipocalin-2, Lipocalins/*urine, Male, Middle Aged, Neoplasm Staging, Nephrectomy/methods, Proto-Oncogene Proteins/*urine, Renal Artery/surgery, Reperfusion Injury/diagnosis/pathology/surgery/*urine, Time Factors},
	pages = {e0146395}
}

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