Evidence map›Paper›PMID 34807337›Full record

ArticleIntensive care medicine experimental2021

Neutrophil gelatinase-associated lipocalin does not originate from the kidney during reperfusion in clinical renal transplantation.

Arie Passov, Minna Ilmakunnas, Marjut Pihlajoki, Kethe Hermunen, Marko Lempinen, Ilkka Helanterä, Villemikko Kailari, Markku Heikinheimo, Sture Andersson, Eero Pesonen

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In one paragraph

Article in Intensive care medicine experimental, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Arie PassovDivision of Anaesthesiology, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, PO BOX 266, 00029 HUS, Helsinki, Finland. arie.passov@hus.fi.ORCID http://orcid.org/0000-0002-4126-610X
Minna IlmakunnasDivision of Anaesthesiology, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, PO BOX 340, 00029 HUS, Helsinki, Finland.
Marjut PihlajokiChildren's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, PO BOX 347, FIN 00029 HUS, Helsinki, Finland.
Kethe HermunenTransplantation and Liver Surgery Clinic, Abdominal Center, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, PO BOX 340, 00029 HUS, Helsinki, Finland.
Marko LempinenTransplantation and Liver Surgery Clinic, Abdominal Center, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, PO BOX 340, 00029 HUS, Helsinki, Finland.
Ilkka HelanteräTransplantation and Liver Surgery Clinic, Abdominal Center, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, PO BOX 340, 00029 HUS, Helsinki, Finland.
Villemikko KailariFaculty of Medicine, University of Helsinki, PO BOX 63, 00014, Helsinki, Finland.
Markku HeikinheimoChildren's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, PO BOX 347, FIN 00029 HUS, Helsinki, Finland.
Sture AnderssonChildren's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, PO BOX 347, FIN 00029 HUS, Helsinki, Finland.
Eero PesonenDivision of Anaesthesiology, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, PO BOX 340, 00029 HUS, Helsinki, Finland.

Funding

Helsinki University Central Hospital EVO grant 2014116Helsinki University Central Hospital EVO grant 2015123
6 · The paper itself

Abstract

backgroundAcute Kidney Injury (AKI) is a common clinical complication. Plasma/serum neutrophil gelatinase-associated lipocalin (NGAL) has been proposed as a rapid marker of AKI. However, NGAL is not kidney-specific. It exists in three isoforms (monomeric, homo-dimeric and hetero-dimeric). Only the monomeric isoform is produced by renal tubular cells and plasma NGAL levels are confounded by the release of all NGAL isoforms from neutrophils. Our aim was to investigate whether NGAL is released into blood from injured renal tubules.

methodsKidney transplantation (n = 28) served as a clinical model of renal ischaemic injury. We used ELISA to measure NGAL concentrations at 2 minutes after kidney graft reperfusion in simultaneously taken samples of renal arterial and renal venous blood. Trans-renal gradients (venous-arterial) of NGAL were calculated. We performed Western blotting to distinguish between renal and non-renal NGAL isoforms. Liver-type fatty acid binding protein (LFABP) and heart-type fatty acid binding protein (HFABP) served as positive controls of proximal and distal tubular damage.

resultsSignificant renal release of LFABP [trans-renal gradient 8.4 (1.7-30.0) ng/ml, p = 0.005] and HFABP [trans-renal gradient 3.7 (1.1-5.0) ng/ml, p = 0.003] at 2 minutes after renal graft reperfusion indicated proximal and distal tubular damage. NGAL concentrations were comparable in renal venous and renal arterial blood. Thus, there was no trans-renal gradient of NGAL. Western blotting revealed that the renal NGAL isoform represented only 6% of the total NGAL in renal venous blood.

conclusionsIschaemic proximal and distal tubular damage occurs in kidney transplantation without concomitant NGAL washout from the kidney graft into blood. Plasma/serum NGAL levels are confounded by the release of NGAL from neutrophils. Present results do not support the interpretation that increase in plasma NGAL is caused by release from the renal tubules.

Indexed as

Acute Kidney InjuryKidney transplantationNeutrophil-gelatinase associated lipocalin

Identifiers

PMID34807337
PMCPMC8608972

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.