Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  

Detalhes bibliográficos
Ano de defesa: 2018
Autor(a) principal: Cezar, Lia Cavalcante
Orientador(a): Garcia, José Huygens Parente
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/33210
Resumo: Acute kidney injury (AKI) is a common complication after liver transplantation. Clinical markers for diagnosis are very limited, which contributed to the search for more specific biomarkers for their early diagnosis. NGAL, renal tubular biomarker and syndecan-1, endothelial biomarker were used in the study. Objectives: To assess the correlation between early detection of NGAL and Syndecan-1 and AKI in patients undergoing liver transplantation, in addition to their ability to predict AKI before creatinine alteration. Methods: A prospective cohort study was carried out at the Walter Cantídio University Hospital and Hospital São Carlos with patients who underwent liver transplantation in 2016. Clinical and epidemiological data were collected, as well as serial serum samples (T1: anesthesia induction, T2: anepatic fase and T3 : 2h post-reperfusion) for analysis of the biomarkers NGAL and Syndecan-1. Results: A total of 46 patients were included in the study, with a mean age of 54 years, of which 60% were male. AKI was observed in 24 cases (61.5%) in the first 7 days of hospitalization. The comparative analysis of the biomarkers in the first 7 days post-transplantation between the groups without and with AKI showed that the single measurement of syndecan-1 2h post reperfusion correlated with the occurrence of AKI (p <0.001). No isolated NGAL value correlated with the occurrence of AKI in the respective study, although the T3 / T2 ratio was related to the occurrence of AKI 7 days after hepatic transplantation. Conclusion: NGAL and Syndecan-1 biomarkers can predict the occurrence of AKI in patients undergoing liver transplantation prior to creatinine clearance. Key words: liver transplantation, NGAL, Syndecan-1, acute kidney injury.
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spelling Cezar, Lia CavalcanteGarcia, José Huygens Parente2018-06-27T12:59:48Z2018-06-27T12:59:48Z2018-06-18CEZAR, L. C. Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático. 2018. 59 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2018.http://www.repositorio.ufc.br/handle/riufc/33210Acute kidney injury (AKI) is a common complication after liver transplantation. Clinical markers for diagnosis are very limited, which contributed to the search for more specific biomarkers for their early diagnosis. NGAL, renal tubular biomarker and syndecan-1, endothelial biomarker were used in the study. Objectives: To assess the correlation between early detection of NGAL and Syndecan-1 and AKI in patients undergoing liver transplantation, in addition to their ability to predict AKI before creatinine alteration. Methods: A prospective cohort study was carried out at the Walter Cantídio University Hospital and Hospital São Carlos with patients who underwent liver transplantation in 2016. Clinical and epidemiological data were collected, as well as serial serum samples (T1: anesthesia induction, T2: anepatic fase and T3 : 2h post-reperfusion) for analysis of the biomarkers NGAL and Syndecan-1. Results: A total of 46 patients were included in the study, with a mean age of 54 years, of which 60% were male. AKI was observed in 24 cases (61.5%) in the first 7 days of hospitalization. The comparative analysis of the biomarkers in the first 7 days post-transplantation between the groups without and with AKI showed that the single measurement of syndecan-1 2h post reperfusion correlated with the occurrence of AKI (p <0.001). No isolated NGAL value correlated with the occurrence of AKI in the respective study, although the T3 / T2 ratio was related to the occurrence of AKI 7 days after hepatic transplantation. Conclusion: NGAL and Syndecan-1 biomarkers can predict the occurrence of AKI in patients undergoing liver transplantation prior to creatinine clearance. Key words: liver transplantation, NGAL, Syndecan-1, acute kidney injury.A lesão renal aguda (LRA) é uma complicação comum pós transplante hepático. Os marcadores clínicos para seu diagnóstico são muito limitados, o que contribuiu na busca de biomarcadores mais específicos para sua detecção precoce. Foram utilizados no estudo o NGAL, biomarcador tubular renal e o syndecan-1, biomarcador endotelial. Objetivos: Avaliar a correlação entre detecção precoce de NGAL e Syndecan-1 e LRA nos pacientes submetidos a transplante hepático, além da sua capacidade em predizer LRA antes da alteração da creatinina. Métodos: Estudo de coorte prospectivo realizado no Hospital Universitário Walter Cantídio e Hospital São Carlos com pacientes que realizaram transplante hepático em 2016. Foram coletados dados clínicos e epidemiológicos, além de amostras séricas seriadas (T1: indução da anestesia, T2: Fase anepática e T3: 2h pós-reperfusão) para análise dos biomarcadores NGAL e Syndecan-1. Resultados: Foram incluídos no estudo 46 pacientes, com média de idade de 54 anos, sendo 60% do sexo masculino. LRA foi observada em 24 casos (61,5%) nos primeiros 7 dias de internação . A análise comparativa dos biomarcadores nos primeiros 7 dias pós-transplante entre os grupos sem e com LRA evidenciou que uma medida única do syndecan-1 2h pós-reperfusão correlacionou-se com a ocorrência de LRA (p<0,001). Nenhum valor isolado do NGAL correlacionou-se com ocorrência de LRA no respectivo estudo, embora a relação T3/T2 teve relação com a ocorrência de LRA 7 dias pós transplante hepático. Conclusão: Os biomarcadores NGAL e Syndecan-1 podem predizer a ocorrência de LRA nos pacientes submetidos a transplante hepático antes da alteração da creatinina.Transplante de FígadoLipocalina-2Lesão Renal AgudaUso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  Use of new biomarkers in the early diagnosis of acute renal injury after liver transplantationinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81812http://repositorio.ufc.br/bitstream/riufc/33210/2/license.txt9351db63ea91b32e01910aaf21c0fd0aMD52ORIGINAL2018_dis_lccezar.pdf2018_dis_lccezar.pdfapplication/pdf714195http://repositorio.ufc.br/bitstream/riufc/33210/3/2018_dis_lccezar.pdf13a4f48f140de480ffad3e755cdb2352MD53riufc/332102018-12-13 14:23:28.91oai:repositorio.ufc.br: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ório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2018-12-13T17:23:28Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
dc.title.en.pt_BR.fl_str_mv Use of new biomarkers in the early diagnosis of acute renal injury after liver transplantation
title Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
spellingShingle Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
Cezar, Lia Cavalcante
Transplante de Fígado
Lipocalina-2
Lesão Renal Aguda
title_short Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
title_full Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
title_fullStr Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
title_full_unstemmed Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
title_sort Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático  
author Cezar, Lia Cavalcante
author_facet Cezar, Lia Cavalcante
author_role author
dc.contributor.author.fl_str_mv Cezar, Lia Cavalcante
dc.contributor.advisor1.fl_str_mv Garcia, José Huygens Parente
contributor_str_mv Garcia, José Huygens Parente
dc.subject.por.fl_str_mv Transplante de Fígado
Lipocalina-2
Lesão Renal Aguda
topic Transplante de Fígado
Lipocalina-2
Lesão Renal Aguda
description Acute kidney injury (AKI) is a common complication after liver transplantation. Clinical markers for diagnosis are very limited, which contributed to the search for more specific biomarkers for their early diagnosis. NGAL, renal tubular biomarker and syndecan-1, endothelial biomarker were used in the study. Objectives: To assess the correlation between early detection of NGAL and Syndecan-1 and AKI in patients undergoing liver transplantation, in addition to their ability to predict AKI before creatinine alteration. Methods: A prospective cohort study was carried out at the Walter Cantídio University Hospital and Hospital São Carlos with patients who underwent liver transplantation in 2016. Clinical and epidemiological data were collected, as well as serial serum samples (T1: anesthesia induction, T2: anepatic fase and T3 : 2h post-reperfusion) for analysis of the biomarkers NGAL and Syndecan-1. Results: A total of 46 patients were included in the study, with a mean age of 54 years, of which 60% were male. AKI was observed in 24 cases (61.5%) in the first 7 days of hospitalization. The comparative analysis of the biomarkers in the first 7 days post-transplantation between the groups without and with AKI showed that the single measurement of syndecan-1 2h post reperfusion correlated with the occurrence of AKI (p <0.001). No isolated NGAL value correlated with the occurrence of AKI in the respective study, although the T3 / T2 ratio was related to the occurrence of AKI 7 days after hepatic transplantation. Conclusion: NGAL and Syndecan-1 biomarkers can predict the occurrence of AKI in patients undergoing liver transplantation prior to creatinine clearance. Key words: liver transplantation, NGAL, Syndecan-1, acute kidney injury.
publishDate 2018
dc.date.accessioned.fl_str_mv 2018-06-27T12:59:48Z
dc.date.available.fl_str_mv 2018-06-27T12:59:48Z
dc.date.issued.fl_str_mv 2018-06-18
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/33210
identifier_str_mv CEZAR, L. C. Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático. 2018. 59 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2018.
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