Effects of pneumoperitoneum on kidney injury biomarkers: A randomized clinical trial

Author(s)

Marton Filho, Marcos Antonio ^{[1, 2]} ; Alves, Rodrigo Leal ^{[3, 4]} ; do Nascimento Junior, Paulo ^[2] ; Tarquinio, Gabriel dos Santos ^[5] ; Mega, Paulo Ferreira ^[6] ; Pinheiro Modolo, Norma Sueli ^[2]

Affiliation

^[1] Ctr Univ Estacio Ribeirao Preto, Ribeirao Preto, SP - Brazil

^[2] Univ Estadual Paulista UNESP, Botucatu Sch Med, Dept Surg Specialties & Anesthesiol, Botucatu, SP - Brazil

^[3] Univ Fed Bahia, Salvador, BA - Brazil

^[4] Sao Rafael Hosp, Dept Anesthesiol, Salvador, BA - Brazil

^[5] Clin Anestesiol Ribeirao Preto CARP, Ribeirao Preto, SP - Brazil

^[6] Pontificia Univ Catolica Campinas PUC CAMPINAS, Sch Med, Campinas, SP - Brazil

• Document type: Journal article
• Source: PLoS One; v. 16, n. 2 FEB 19 2021.
• Web of Science Citations: 0

Abstract

Background Increased intra-abdominal pressure causes hemodynamic changes that may affect renal biomarkers. Methods This randomized, single-blind, single-center clinical trial recruited patients undergoing laparoscopic cholecystectomy at a tertiary care center in Brazil. They were randomly allocated to a standard intra-abdominal pressure group (P10-12, 10-12 mm Hg) and a low intra-abdominal pressure group (P6-8, 6-8 mm Hg). The primary outcome was the change in neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C levels measured at the beginning of the procedure (T0), at the end of the procedure (T1), and 24 hours after the procedure (T2). P-values < 0.05 were considered statistically significant. Results In total, 64 patients completed the study-33 were given standard pressure and 31 were given low pressure. There was no significant difference in the biomarker between the groups (P = 0.580), but there was a significant difference between the time points with elevation at T1 (P < 0.001). Similar to NGAL, cystatin C had an elevation at T1 in both groups (P = 0.021), but no difference was found when comparing the groups. Conclusions In laparoscopic cholecystectomy, pneumoperitoneum increases NGAL and cystatin C levels intraoperatively, and the use of low-pressure pneumoperitoneum does not change the course of these biomarkers. (AU)

• FAPESP's process: 17/27032-0 - VARIATIONS IN NGAL VALUES IN PATIENTS SUBMITTED TO PNEUMOPERITONEUM WITH LOW AND STANDARD PRESSURE
• Grantee: Norma Sueli Pinheiro Módolo
• Support Opportunities: Regular Research Grants