Dynamics of Urinary Calprotectin after Renal Ischaemia
Dynamics of Urinary Calprotectin after Renal Ischaemia
复制标题
DOI：
10.1371/journal.pone.0146395
复制
发表时间：
2016-01-08
期刊：
影响因子：
3.7
通讯作者：
Westhoff, Timm H.
中科院分区：
文献类型：
--
作者：
Ebbing, Jan;Seibert, Felix S.;Westhoff, Timm H.
背景：尿钙卫蛋白已被确定为急性肾损伤的有前景的生物标志物。然而迄今为止，急性肾损伤期间该参数随时间的变化仍然难以捉摸。目前工作的目的是与中性粒细胞明胶酶相关的脂质运载蛋白相比，确定缺血/再灌注引起的肾损伤后尿钙卫蛋白分泌的时间过程，从而监测肾肿瘤保留肾单位手术中肾小管损伤的程度。方法：研究人群包括 42 名患者。 32 名患者接受了开放式或内窥镜下肾肿瘤保留肾单位手术。术中26例患者肾动脉蒂被夹闭，中位缺血时间为13分钟（四分位距4.5-20.3分钟）。 10例后腹腔镜活体供肾切除患者和6例未夹闭肾动脉的保留肾单位手术患者作为对照。通过酶联免疫吸附测定重复测量尿钙卫蛋白和中性粒细胞明胶酶相关脂质运载蛋白浓度，并根据肾功能参数进行评估。结果：缺血/再灌注损伤后尿钙卫蛋白和中性粒细胞明胶酶相关脂质运载蛋白浓度显着增加，而在无缺血/再灌注损伤的肾单位保留手术后和肾脏捐献后浓度保持不变。钙卫蛋白和中性粒细胞明胶酶相关脂质运载蛋白水平分别在缺血后2小时和8小时显着增加。两种蛋白质在 48 小时后达到最大浓度，随后持续下降。最大中性粒细胞明胶酶相关脂质运载蛋白和钙卫蛋白浓度分别比各自的基线值高 9 倍和 69 倍。缺血/再灌注损伤后第一天，肾小球滤过率仅短暂受损（p = 0.049）。结论：钙卫蛋白和中性粒细胞明胶酶相关脂质运载蛋白可用于监测肾脏肿瘤保留肾单位手术后的临床和亚临床肾小管损伤。缺血/再灌注引起的肾损伤后 2 小时内尿钙卫蛋白浓度开始上升。
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 timecourse 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.