Rapid detection of acute kidney injury by urinary neutrophil gelatinase-associated lipocalin after cardiopulmonary bypass surgery

Acute kidney injury (AKI) is common following cardiac operations under cardiopulmonary bypass (CPB) and predicts a poor outcome. Morbidity and mortality increase with delay in diagnosing the condition. Detection of AKI are diagnosed only following a significant rise in serum creatinine. Serial serum creatinine measurement is not reliable during early phase of kidney dysfunction. Timely intervention is only possible with early diagnosis of AKI by means of effective biomarkers which can provent progression to further renal injury. Neutrophil gelatinase-associated lipocalin (NGAL) is a potential marker for AKI. It is normally expressed in low concentration and is significantly increased in case of epithelial damage. Urine NGAL is of excellent value in identifying patients suffering from AKI. The aim of this study was to determine the accuracy of urinary NGAL levels following cardiac surgery under CBP to establish severity of renal impairment as compared to serum creatinine levels and to determine to appropriate cutoff post-CPB.