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The Predictive Role of Biomarkers for the Detection of Acute Kidney Injury After Partial or Radical Nephrectomy:A Systematic Review of the Literature

Author:
Antonelli, Alessandro  Allinovi, Marco  Cocci, Andrea  Russo, Giorgio Ivan  Schiavina, Riccardo  Rocco, Bernardo  Giovannalberto, Pini  Celia, Antonio  Galfano, Antonio  Varca, Virginia  Bozzini, Giorgio  Ceruti, Carlo  Greco, Francesco  Verze, Paolo  Pastore, Antonio Luigi  Porreca, Angelo  Minervini, Andrea  


Journal:
EUROPEAN UROLOGY FOCUS


Issue Date:
2020


Abstract(summary):

Context: Postoperative acute kidney injury (AKI) is a serious complication after kidney surgery, associated with prolonged hospital stay, high morbidity, and mortality. Biomarkers represent a tool of increasing importance to identify renal impairment after partial nephrectomy(PN) or radical nephrectomy (RN) in order to optimize and anticipate the diagnosis of AKI. Objective: The goal of this systematic review is to investigate current insights on the role of biomarkers in predicting renal impairment in patients undergoing PN or RN. Evidence acquisition: A systematic review was conducted up to November 30, 2017 through PubMed, Scopus, and Embase databases, to identify eligible studies evaluating the role of biomarkers for the prediction ofAKI after PN or RN. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria were applied to select articles. Evidence synthesis: According to the study selection criteria, 10 publications were included with a total number of 728 patients. Incidence of AKI was 26.7% (range: 9-58%). Based on the evidence reviewed, serum cystatin C and urinary neutrophil gelatinase-associated lipocalin (NGAL) showed a significant correlation with serum creatinine rise postoperatively, emerging as potential noninvasive and early biomarkers of AKI in patients undergoing renal surgery. In this setting, serum cystatin C and urinary NGAL have preceded the rise in serum creatinine peak from 3 up to 24 h, even in case of mild renal damage. Conclusions: The literature underlines the potential usefulness of biomarkers such as cystatin C and NGAL as promising and early tools to predict AKI after PN or RN. However, no strong evidence in support of their use is available to date and further investigations are awaited. Patient summary: We looked at the role of biomarkers in predicting renal injury in patients undergoing partial or radical nephrectomy. Serum cystatin C and urinary neutrophil gelatinase-associated lipocalin have emerged as promising noninvasive. accurate, and early biomarkers. (C) 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.


Page:
344---353


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