Preoperative urine neutrophil gelatinase‐associated lipocalin predicts mortality in colorectal cancer patients after laparoscopic surgery: A single‐center study

Abstract

Abstract Purpose To determine the rate of acute kidney injury (AKI) after laparoscopic colorectal cancer (CRC) surgery and the predictive value of urine neutrophil gelatinase‐associated lipocalin (uNGAL) for postoperative AKI and mortality during 3 years of follow‐up. Methods A total of 216 CRC patients who had undergone laparoscopic surgery were included in our study. We divided all patients into two groups, including group 1 (n = 31) with postoperative AKI and group 2 (n = 185) without postoperative AKI. Urine NGAL was measured using the ELISA technique. Clinical and laboratory data were collected the day before surgery. Postoperative AKI included events occurring within 7 days of the index operation, and mortality was obtained during 3 years of follow‐up. Results The ratio of postoperative AKI was 14.35% (31/216 patients). The urine NGAL level in group 1 was significantly higher than in group 2, p < 0.001. At cut‐off value = 14.94 ng/mL, uNGAL has a predictive value for AKI (area under the curve [AUC] = 0.858, p < 0.001). After 3 years of follow‐up, the total mortality rate was 7.9%. The mortality rate in group 1 (45.2%) was significantly higher than in group 2 (1.6%) with p < 0.001). At cut‐off value = 19.85 ng/mL, uNGAL has a predictive value for mortality (AUC = 0.941, p < 0.001). Conclusions The rate of acute kidney injury after laparoscopic CRC surgery was 14.35%. Preoperative urine NGAL has a good predictive value for postoperative acute kidney injury and mortality during 3 years of follow‐up.

Keywords

• AKI
• colorectal cancer
• laparoscopic surgery
• mortality
• urine NGAL