Title:The Clinical Utility and Assessment of Renal Biomarkers in Acute Kidney Injury After Abdominal Endovascular Aneurysm Repair. A Systematic Review
Volume: 25
Issue: 44
Author(s): Georgios Karaolanis, Zachary F. Williams, Chris Bakoyiannis, Dimitrios Hadjis , Mitchell W. Cox and Dimitrios Moris*
Affiliation:
- Duke Surgery, Duke University Medical Center, Durham, NC, 27708,United States
Keywords:
Abdominal aortic aneurysm, acute kidney injury, biomarkers, endovascular repair, systematic review, systematic reviews and
meta-analyses.
Abstract: The widespread adoption of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms
(AAA) is due to the obvious advantages of the procedure compared to the traditional open repair. However, these
advantages have to be weighed against the increased risk of renal dysfunction with EVAR. The evaluation of the
perioperative renal function after EVAR has been hampered by the lack of sensitive and specific biochemical
markers of acute kidney injury (AKI). The purpose of this study was to summarize all novel renal biomarkers and
to evaluate their clinical utility for the assessment of the kidney function after EVAR. A systematic review of the
current literature, as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines,
was performed to identify relevant studies with novel renal biomarkers and EVAR. Pubmed and Scopus
databases were systemically searched. Studies reporting on thoracic endovascular aortic repair (TEVAR), case
reports, case series, letters to the editor, and systematic reviews were excluded. Neutrophil-Gelatinase-Associated
Lipocalin, Cystatin C, Liver-type fatty-acid-binding protein were the most common among the eligible studies
while Interleukin-18, Retinol binding protein, N-acetyle-b-D-glucosaminidase and microalbumin have a sparse
appearance in the literature. These biomarkers have been assessed in plasma as well as urine samples with each
sample material having its own advantages and drawbacks. Which of these biomarkers has the most potential for
assessing postoperative renal failure after EVAR, remains to be proved. The few studies presented in the literature
show the potential clinical utility of these biomarkers, but larger studies with longer follow-up are required to
determine the precise relationship between these biomarkers and postoperative acute kidney injury.