Clinical Investigation Into Plasma Neutrophil Gelatinase-Associated Lipocalin and Body Adipose Tissue Associated With Remaining Renal Function in Living Kidney Donor.

Abstract

Objective. Plasma neutrophil gelatinase-associated lipocalin (pNGAL) is known to increase in proportion to the degree and period of renal damage. This study aimed to evaluate the clinical relevance of pNGAL and body adipose tissue to remaining renal function in living kidney donors.

Methods. Between July 2013 and February 2015, 75 live kidney donors were enrolled. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and VAT/SAT ratio were measured in preoperative CT scan which performed before surgery. We analyzed the correlation among the variables (VAT, SAT, and VAT/SAT ratio), eGFR and pNGAL. Delta pNGAL-max(=Maximum pNGAL-measures), Delta pNGAL-min(=Minimum pNGAL-measures), Delta eGFR-max(=Maximum eGFR-measures) and Delta eGFR-min(=Minimum eGFR-measures) were also analyzed.

Results. The highest value of pNGAL (207.46 +/- 76 ng/mL) was observed on postoperative day 7, and the lowest value of eGFR (57.52 +/- 11.20 mL/min/1.73 m(2)) was also measured on postoperative day 7. A significant correlation was found between Delta pNGAL, VAT, and VAT-to-SAT ratio. Moreover, a significant correlation between Delta pNGALmin and Delta eGFRmin was revealed. Also, VAT-to-SAT ratio was correlated with Delta eGFRmin during the all of the follow-up periods, and it was also correlated with Delta pNGALmin until postoperative day 3.

Conclusion. There was a correlation between the elevation of pNGAL until postoperative day 5 and the decrease of eGFR after living donor nephrectomy. VAT-to-SAT ratio had a significant correlation with both Delta pNGALmin and eGFRmin. Given the metabolism of pNGAL, the increase of pNGAL seemed to be affected as a consequence of body adipose tissue.