Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>We examined the value of the novel acute kidney injury (<jats:styled-content style="fixed-case">AKI</jats:styled-content>) markers neutrophil gelatinase‐associated lipocalin (<jats:styled-content style="fixed-case">NGAL</jats:styled-content>) and kidney injury molecule‐1 (<jats:styled-content style="fixed-case">KIM</jats:styled-content>‐1) in acute postrenal impairment. These biomarkers have been evaluated in prerenal and intrarenal <jats:styled-content style="fixed-case">AKI</jats:styled-content> so far, but not in human acute postrenal kidney injury. With regard to multimorbid and critically ill patients the discrimination of different <jats:styled-content style="fixed-case">AKI</jats:styled-content> origins often remains a challenge. As the trend goes towards a diagnostic panel of <jats:styled-content style="fixed-case">AKI</jats:styled-content> markers, we hereby aim to contribute to evaluate further options of discrimination in an observational case‐control study.</jats:p></jats:sec><jats:sec><jats:title>Materials and methods</jats:title><jats:p>Blood and urine samples were obtained from 53 patients with acute obstructive nephropathy secondary to ureteral calculi and 52 age‐matched healthy controls. Serum NGAL (<jats:styled-content style="fixed-case">sNGAL</jats:styled-content>), urinary NGAL (<jats:styled-content style="fixed-case">uNGAL</jats:styled-content>) and urinary KIM‐1 (<jats:styled-content style="fixed-case">uKIM</jats:styled-content>‐1) levels were determined using a commercially available ELISA kit, creatinine applying the Jaffé's method.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>While urinary levels of KIM‐1 were not significantly different between patients with obstructive nephropathy and controls, a striking increase in <jats:styled-content style="fixed-case">sNGAL</jats:styled-content> (<jats:italic>P</jats:italic> < 0·001) and <jats:styled-content style="fixed-case">uNGAL</jats:styled-content> (<jats:italic>P</jats:italic> < 0·01) levels was detected in the obstructive nephropathy group. Within the obstructive nephropathy group, <jats:styled-content style="fixed-case">sNGAL</jats:styled-content> (<jats:italic>P</jats:italic> = 0·01) and <jats:styled-content style="fixed-case">uNGAL</jats:styled-content> (<jats:italic>P</jats:italic> = 0·049) but not <jats:styled-content style="fixed-case">uKIM</jats:styled-content>‐1 correlated positively with the white blood cell count and <jats:styled-content style="fixed-case">uNGAL</jats:styled-content> correlated positively (<jats:italic>P</jats:italic> = 0·002) with the extent of leucocyturia.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>High levels of <jats:styled-content style="fixed-case">sNGAL</jats:styled-content> and <jats:styled-content style="fixed-case">uNGAL</jats:styled-content> observed in stone‐induced acute obstructive nephropathy may represent a valuable marker of postrenal AKI. Low <jats:styled-content style="fixed-case">uKIM</jats:styled-content>‐1 levels may help to discriminate postrenal AKI events using a panel of markers in this setting.</jats:p></jats:sec>