Novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot study
Abstract Background The feasibility of novel kidney injury biomarkers in consecutive patients having total knee arthroplasty with local infiltration analgesia was evaluated. Methods We enrolled 30 patients scheduled for elective unilateral total knee arthroplasty. Paired plasma and urine samples wer...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-09-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | http://link.springer.com/article/10.1186/s40634-018-0159-z |
| _version_ | 1797330565341380608 |
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| author | Annika Piirainen Jukka Huopio Hannu Kokki Anu Holopainen Teemu Pajunen Kari Pulkki Merja Kokki |
| author_facet | Annika Piirainen Jukka Huopio Hannu Kokki Anu Holopainen Teemu Pajunen Kari Pulkki Merja Kokki |
| author_sort | Annika Piirainen |
| collection | DOAJ |
| description | Abstract Background The feasibility of novel kidney injury biomarkers in consecutive patients having total knee arthroplasty with local infiltration analgesia was evaluated. Methods We enrolled 30 patients scheduled for elective unilateral total knee arthroplasty. Paired plasma and urine samples were taken before surgery and at 4 h, 24 h and 48 h after surgery to measure creatinine, cystatin C, neutrophil gelatinase associated lipocalin, kidney injury molecule-1, interleukin-18 and liver-type fatty acid-binding protein. Results At baseline, 13 subjects had normal kidney function, 15 had mild and two had moderate kidney failure evaluated by calculated glomerular filtration rate. None of the subjects had all measured novel renal markers below proposed cut-off concentrations. Altogether 28/30 subjects had one (n = 3), two (n = 7) or three (n = 18) plasma neutrophil gelatinase associated lipocalin values above normal. In seven of these 28 subjects plasma creatinine, calculated glomerular filtration rate and plasma cystatin C were within the reference values. Five subjects had a low urine output, < 0.5 mL/h, indicating transient acute kidney injury, four of these had high plasma neutrophil gelatinase associated lipocalin and one high plasma cystatin C. Conclusions In the present study plasma neutrophil gelatinase associated lipocalin was elevated in most subjects with total knee arthroplasty and local infiltration analgesia as a marker of possible renal proximal tubular injury. Five subjects had transient low urine output, but none developed renal deterioration requiring treatment. |
| first_indexed | 2024-03-08T07:21:36Z |
| format | Article |
| id | doaj.art-ae0f814e7eaf4ea9be883f81adabb317 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T07:21:36Z |
| publishDate | 2018-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-ae0f814e7eaf4ea9be883f81adabb3172024-02-02T23:22:07ZengSpringerOpenJournal of Experimental Orthopaedics2197-11532018-09-01511810.1186/s40634-018-0159-zNovel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot studyAnnika Piirainen0Jukka Huopio1Hannu Kokki2Anu Holopainen3Teemu Pajunen4Kari Pulkki5Merja Kokki6Anaesthesia and Operative Services, Kuopio University HospitalDepartment of Orthopaedics, Traumatology and Hand Surgery, Kuopio University HospitalDepartment of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern FinlandEastern Finland Laboratory Centre Joint Authority Enterprise (ISLAB)Department of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern FinlandEastern Finland Laboratory Centre Joint Authority Enterprise (ISLAB)Anaesthesia and Operative Services, Kuopio University HospitalAbstract Background The feasibility of novel kidney injury biomarkers in consecutive patients having total knee arthroplasty with local infiltration analgesia was evaluated. Methods We enrolled 30 patients scheduled for elective unilateral total knee arthroplasty. Paired plasma and urine samples were taken before surgery and at 4 h, 24 h and 48 h after surgery to measure creatinine, cystatin C, neutrophil gelatinase associated lipocalin, kidney injury molecule-1, interleukin-18 and liver-type fatty acid-binding protein. Results At baseline, 13 subjects had normal kidney function, 15 had mild and two had moderate kidney failure evaluated by calculated glomerular filtration rate. None of the subjects had all measured novel renal markers below proposed cut-off concentrations. Altogether 28/30 subjects had one (n = 3), two (n = 7) or three (n = 18) plasma neutrophil gelatinase associated lipocalin values above normal. In seven of these 28 subjects plasma creatinine, calculated glomerular filtration rate and plasma cystatin C were within the reference values. Five subjects had a low urine output, < 0.5 mL/h, indicating transient acute kidney injury, four of these had high plasma neutrophil gelatinase associated lipocalin and one high plasma cystatin C. Conclusions In the present study plasma neutrophil gelatinase associated lipocalin was elevated in most subjects with total knee arthroplasty and local infiltration analgesia as a marker of possible renal proximal tubular injury. Five subjects had transient low urine output, but none developed renal deterioration requiring treatment.http://link.springer.com/article/10.1186/s40634-018-0159-zArthroplasty, replacement, kneeAcute kidney injuryNeutrophil gelatinase associated lipocalinKidney injury molecule-1 proteinCreatinineGlomerular filtration rate |
| spellingShingle | Annika Piirainen Jukka Huopio Hannu Kokki Anu Holopainen Teemu Pajunen Kari Pulkki Merja Kokki Novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot study Journal of Experimental Orthopaedics Arthroplasty, replacement, knee Acute kidney injury Neutrophil gelatinase associated lipocalin Kidney injury molecule-1 protein Creatinine Glomerular filtration rate |
| title | Novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot study |
| title_full | Novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot study |
| title_fullStr | Novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot study |
| title_full_unstemmed | Novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot study |
| title_short | Novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty – a pilot study |
| title_sort | novel renal markers for the assessment of renal integrity in patients undergoing knee arthroplasty a pilot study |
| topic | Arthroplasty, replacement, knee Acute kidney injury Neutrophil gelatinase associated lipocalin Kidney injury molecule-1 protein Creatinine Glomerular filtration rate |
| url | http://link.springer.com/article/10.1186/s40634-018-0159-z |
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