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A human model of intra-abdominal hypertension: even slightly elevated pressures lead to increased acute systemic inflammation and signs of acute kidney injury.

Smit M, Hofker HS, Leuvenink HG, Krikke C, Jongman RM, Zijlstra JG, van Meurs M - Crit Care (2013)

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Markers of systemic inflammation - C-reactive protein (CRP) and interleukin-6 (IL-6) - were determined in both groups peri-operatively... These results were previously published in a large study on the effect of different operative procedures on outcome of kidney donors... NGAL in plasma was 1.2 times higher just before extraction of the kidney in the laparoscopic group... NGAL in urine did not change (Figure 1)... Although procedure time is shorter, laparoscopic nephrectomy leads to increased inflammation and signs of renal injury... It is tempting to hypothesize that even mild IAH leads to mildly increased systemic inflammation and increased plasma NGAL as a sign of acute kidney injury in this group... Other factors such as operative technique or inflammation caused by carbon dioxide gas may contribute... Further studies to dissect the contributions of inflammation, hemodynamics, and local pressure effects on renal injury in IAH are warranted... CRP: C-reactive protein; IAH: intra-abdominal hypertension; IAP: intraabdominal pressure; IL-6: interleukin-6; NGAL: neutrophil gelatinase-associated lipocalin... The authors declare that they have no competing interests.

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Plasma and urine markers of renal function. (a) Neutrophil gelatinase-associated lipocalin (NGAL) in plasma was measured by using commercially available enzyme-linked immunosorbent assay (ELISA) kits in accordance with the instructions of the manufacturer (DLCN20; R&D Systems, Minneapolis, MN, USA). (b) NGAL in urine was measured by using ELISA (DLCN20; R&D Systems). Dots represent the laparoscopic group, and squares represent the open nephrectomy group (n = 50). *P <0.05.
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Figure 1: Plasma and urine markers of renal function. (a) Neutrophil gelatinase-associated lipocalin (NGAL) in plasma was measured by using commercially available enzyme-linked immunosorbent assay (ELISA) kits in accordance with the instructions of the manufacturer (DLCN20; R&D Systems, Minneapolis, MN, USA). (b) NGAL in urine was measured by using ELISA (DLCN20; R&D Systems). Dots represent the laparoscopic group, and squares represent the open nephrectomy group (n = 50). *P <0.05.

Mentions: Markers of systemic inflammation - C-reactive protein (CRP) and interleukin-6 (IL-6) - were determined in both groups peri-operatively. These results were previously published in a large study on the effect of different operative procedures on outcome of kidney donors [4]. As a marker of renal function, neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine was determined in both groups at the start of the procedure and just before extraction of the donor kidney. All data are expressed as means with standard deviations. Paired t tests were performed to test for statistical significance at every time point; a P value of less than 0.05 was considered statistically significant. CRP was 1.5 times higher after 24 hours and 1.3 times higher after 48 hours in the laparoscopic group. IL-6 was 1.5 times higher after 12 hours in the laparoscopic group. NGAL in plasma was 1.2 times higher just before extraction of the kidney in the laparoscopic group. NGAL in urine did not change (Figure 1).


A human model of intra-abdominal hypertension: even slightly elevated pressures lead to increased acute systemic inflammation and signs of acute kidney injury.

Smit M, Hofker HS, Leuvenink HG, Krikke C, Jongman RM, Zijlstra JG, van Meurs M - Crit Care (2013)

Plasma and urine markers of renal function. (a) Neutrophil gelatinase-associated lipocalin (NGAL) in plasma was measured by using commercially available enzyme-linked immunosorbent assay (ELISA) kits in accordance with the instructions of the manufacturer (DLCN20; R&D Systems, Minneapolis, MN, USA). (b) NGAL in urine was measured by using ELISA (DLCN20; R&D Systems). Dots represent the laparoscopic group, and squares represent the open nephrectomy group (n = 50). *P <0.05.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3672475&req=5

Figure 1: Plasma and urine markers of renal function. (a) Neutrophil gelatinase-associated lipocalin (NGAL) in plasma was measured by using commercially available enzyme-linked immunosorbent assay (ELISA) kits in accordance with the instructions of the manufacturer (DLCN20; R&D Systems, Minneapolis, MN, USA). (b) NGAL in urine was measured by using ELISA (DLCN20; R&D Systems). Dots represent the laparoscopic group, and squares represent the open nephrectomy group (n = 50). *P <0.05.
Mentions: Markers of systemic inflammation - C-reactive protein (CRP) and interleukin-6 (IL-6) - were determined in both groups peri-operatively. These results were previously published in a large study on the effect of different operative procedures on outcome of kidney donors [4]. As a marker of renal function, neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine was determined in both groups at the start of the procedure and just before extraction of the donor kidney. All data are expressed as means with standard deviations. Paired t tests were performed to test for statistical significance at every time point; a P value of less than 0.05 was considered statistically significant. CRP was 1.5 times higher after 24 hours and 1.3 times higher after 48 hours in the laparoscopic group. IL-6 was 1.5 times higher after 12 hours in the laparoscopic group. NGAL in plasma was 1.2 times higher just before extraction of the kidney in the laparoscopic group. NGAL in urine did not change (Figure 1).

View Article: PubMed Central - HTML - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Markers of systemic inflammation - C-reactive protein (CRP) and interleukin-6 (IL-6) - were determined in both groups peri-operatively... These results were previously published in a large study on the effect of different operative procedures on outcome of kidney donors... NGAL in plasma was 1.2 times higher just before extraction of the kidney in the laparoscopic group... NGAL in urine did not change (Figure 1)... Although procedure time is shorter, laparoscopic nephrectomy leads to increased inflammation and signs of renal injury... It is tempting to hypothesize that even mild IAH leads to mildly increased systemic inflammation and increased plasma NGAL as a sign of acute kidney injury in this group... Other factors such as operative technique or inflammation caused by carbon dioxide gas may contribute... Further studies to dissect the contributions of inflammation, hemodynamics, and local pressure effects on renal injury in IAH are warranted... CRP: C-reactive protein; IAH: intra-abdominal hypertension; IAP: intraabdominal pressure; IL-6: interleukin-6; NGAL: neutrophil gelatinase-associated lipocalin... The authors declare that they have no competing interests.

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