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Concentration of neutrophil gelatinase-associated lipocalin (NGAL) in serum obtained from different vascular areas during surgical repair of abdominal aortic aneurysm
1
Klinika Chorób Wewnętrznych i Metabolicznych, Wydział Nauk o Zdrowiu w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
2
Katedra i Klinika Chirurgii Ogólnej, Naczyń, Angiologii i Flebologii, Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
3
Oddział Chirurgii Onkologicznej z Pododdziałem Chirurgii Naczyniowej, Katowickie Centrum Onkologii
Corresponding author
Leszek Kędzierski
Klinika Chorób Wewnętrznych i Metabolicznych, Górnośląskie Centrum Medyczne im. prof. Leszka Gieca, Śląski Uniwersytet Medyczny w Katowicach, ul. Ziołowa 45/47, 40-635 Katowice
Klinika Chorób Wewnętrznych i Metabolicznych, Górnośląskie Centrum Medyczne im. prof. Leszka Gieca, Śląski Uniwersytet Medyczny w Katowicach, ul. Ziołowa 45/47, 40-635 Katowice
Ann. Acad. Med. Siles. 2019;73:89-95
KEYWORDS
neutrophil gelatinase-associated lipocalin (NGAL)abdominal aortic aneurysm (AAA) surgeryacute kidney injury (AKI)
TOPICS
ABSTRACT
Introduction:
Neutrophil gelatinase-associated lipocalin (NGAL) is a secretory protein found in neutrophils, endothelial cells and in various organs of the gastrointestinal, respiratory, excretory and reproductive systems. NGAL, involved in inflammatory processes in cells, is regarded to be the early indicator of renal dysfunction. The surgical repair of an abdominal aortic aneurysm (AAA) is a research model of acute kidney injury. There is iatrogenic kidney injury during that intervention. The surgical technique allows the blood from various vascular areas to be collected.
Material and methods:
The study group consisted of 21 patients with AAA who were planned to undergo surgical treatment. The serum concentration of NGAL was determined in blood: from a peripheral vein before surgery, just before removal of the aortic clamp, 5 minutes after removal of the aortic clamp; from the renal vein prior to aorta clamping, just before removal of the aortic clamp, 5 minutes after removal of the aortic clamp; from the inferior vena cava just before removal of the aortic clamp.
Results:
The serum concentration of NGAL in the samples obtained from the peripheral vein significantly increased after the surgery. Just before removal of the aortic clamp, a significantly higher concentration of NGAL was found in the serum obtained from the inferior vena cava compared to the renal vein.
Conclusions:
The increase in serum concentration of NGAL after surgical repair of AAA mainly results from a greater inflow of this cytokine into the systemic circulation from vascular areas of the lower part of body, which is ischemic due to the aortic clamp.
Neutrophil gelatinase-associated lipocalin (NGAL) is a secretory protein found in neutrophils, endothelial cells and in various organs of the gastrointestinal, respiratory, excretory and reproductive systems. NGAL, involved in inflammatory processes in cells, is regarded to be the early indicator of renal dysfunction. The surgical repair of an abdominal aortic aneurysm (AAA) is a research model of acute kidney injury. There is iatrogenic kidney injury during that intervention. The surgical technique allows the blood from various vascular areas to be collected.
Material and methods:
The study group consisted of 21 patients with AAA who were planned to undergo surgical treatment. The serum concentration of NGAL was determined in blood: from a peripheral vein before surgery, just before removal of the aortic clamp, 5 minutes after removal of the aortic clamp; from the renal vein prior to aorta clamping, just before removal of the aortic clamp, 5 minutes after removal of the aortic clamp; from the inferior vena cava just before removal of the aortic clamp.
Results:
The serum concentration of NGAL in the samples obtained from the peripheral vein significantly increased after the surgery. Just before removal of the aortic clamp, a significantly higher concentration of NGAL was found in the serum obtained from the inferior vena cava compared to the renal vein.
Conclusions:
The increase in serum concentration of NGAL after surgical repair of AAA mainly results from a greater inflow of this cytokine into the systemic circulation from vascular areas of the lower part of body, which is ischemic due to the aortic clamp.
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