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Salivary Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Cortisol measurement in acute Renal Colic

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Sources of Funding: NONE

Introduction

_x000D_ Introduction _x000D_ _x000D_ In acute ureteral stone obstruction the decision to treat is sometimes missing a forecaster for a better outcome. Neutrophil Gelatinase-Associated Lipocalin (NGAL) levels are predictive biomarker of Acute Kidney Injury (AKI) with correlation to complication and survival in major surgery. NGAL is particularly expressed during the first 24 hours in the proximal tubules. Cortisol levels in saliva found to be a reliable parameter for stress. Salivary levels of NGAL during renal colic were not evaluated so far._x000D_ OBJECTIVE_x000D_ To measure salivary NGAL and Cortisol levels in patients presented to the Emergency Room (ER) with acute renal colic_x000D_

Methods

Prospective controlled study of all patients who presented to ER with acute renal colic and diagnosed with single ureteric stone obstruction by non-contrast computed tomography (NCCT). Saliva, urine and blood samples were collected in patients and control group during the first morning of admission. Salivent system was used to collect the salivary samples for Human Lipocalin-2/NGAL Quantikine ELISA Kit test and for Cortisol. A questionnaire was used to evaluate patient's repose, and clinical data were collected. _x000D_ _x000D_ _x000D_

Results

44 patients in the study group, 13 in the control group, mean age 48±13 years, BMI 28±6, mean stone size 6±4 mm , mean VAS scored of 7±2 ,mean creatinine levels of 1.3±0.3 mgr/dl ,mean WBC 10,900±3,100 count per field ,CRP 29±55 .23 (53%) of patient underwent urgent intervention. Serum (199±154 vs 81±24, p < 0.001) and, predominantly Salivary (474±185 vs 328±134; p < 0.05) NGAL levels were significantly elevated in patients with acute renal colic in comparison to controls. Cortisol level on the contrary did not demonstrate any increase during acute phase of renal colic, suggestive a delay response or suppression mechanism._x000D_ _x000D_

Conclusions

Salivary and blood NGAL sampling is feasible during acute phase of renal colic. High levels of salivary NGAL are observed in a single sampling during acute ureteral stone obstruction and may advance clinical decision making. Cortisol levels fail to increased suggestive of some suppression mechanism.

Funding

NONE

Authors
Ashraf Tamimi
Eyal Kord
Yishai Rapaport
Ramziya Abu hamad
Shai Efrati
Amnon Zisman
Yoram Siegel
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