Article Data

  • Views 491
  • Dowloads 172

Original Research

Open Access Special Issue

NGAL in trans-catheter aortic valve implantation on and off RenalGuard

  • Sapir Sadon1
  • Yaron Arbel1
  • Ariel Banai1
  • Keren-Lee Rozenfeld1
  • Phillipe Taieb1
  • Aviram Hochstadt1
  • Yacov Shacham1
  • Shmuel Banai1
  • Ariel Finkelstein1
  • Ilan Merdler1

1Department of Cardiology, Tel Aviv Sourasky Medical Center, Israel. Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

DOI: 10.22514/sv.2021.048 Vol.17,Issue 4,July 2021 pp.55-59

Submitted: 05 January 2021 Accepted: 22 January 2021

Published: 08 July 2021

*Corresponding Author(s): Yaron Arbel E-mail:


Introduction: Acute kidney injury (AKI) is a well-known complication post invasive cardiac procedures. RenalGuard system has been shown to reduce the risk of AKI in high-risk patients by evacuating iodine-based contrast material rapidly. Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein stored in granules of mature neutrophils and is released to the blood stream due to acute tubular damage. This report examined the biomarker as a sub study of the randomized sham control study REDUCE-AKI in the setting of Trans-Aortic Valve Implantation (TAVI).

Methods: Venous blood was drawn from 27 patients. Blood was drawn at designated time intervals: before the procedure, after 12 hours and after 24 hours. Patients were randomly allocated to active versus sham RenalGuard activity.

Results: There was no difference between baseline and 24 hours levels in NGAL values (ng/mL) in the sham group (median 70.3 IQ 21.5, 176.6) versus the active group (median 46.9, IQR 1.3, 127.7) (P = 0.259). There was also no association between NGAL and clinical complications.

Conclusion: Forced diuresis with matched hydration does not prevent AKI in patients undergoing TAVI and measuring NGAL correlates with these findings.



Cite and Share

Sapir Sadon,Yaron Arbel,Ariel Banai,Keren-Lee Rozenfeld,Phillipe Taieb,Aviram Hochstadt,Yacov Shacham,Shmuel Banai,Ariel Finkelstein,Ilan Merdler. NGAL in trans-catheter aortic valve implantation on and off RenalGuard. Signa Vitae. 2021. 17(4);55-59.


[1] Kliuk-Ben Bassat O, Finkelstein A, Bazan S, Halkin A, Herz I, Salzer Gotler D, et al. Acute kidney injury after transcatheter aortic valve implantation and mortality risk-long-term follow-up. Nephrology Dialysis Transplantation. 2020; 35: 433-438.

[2] Lo K, Penalver J, Mostafavi Toroghi H, Jeon H, Habib N, Hung Pinto W, et al. Invasive hemodynamic predictors of renal outcomes after percutaneous coronary interventions. Cardiorenal Medicine. 2019; 9: 382-390.

[3] Arbel Y, Ben-Assa E, Puzhevsky D, Litmanowicz B, Galli N, Chorin E, et al. Forced diuresis with matched hydration during transcatheter aortic valve implantation for reducing acute kidney injury: a randomized, sham-controlled study (REDUCE-AKI). European Heart Journal. 2019; 40: 3169-3178.

[4] Bagur R, Webb JG, Nietlispach F, Dumont E, De Larochelliere R, Doyle D, et al. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. European Heart Journal. 2010; 31: 865-874.

[5] Attard S, Buttigieg J, Galea S, Mintoff M, Farrugia E, Cassar A. The incidence, predictors, and prognosis of acute kidney injury after transcatheter aortic valve implantation. Clinical Nephrology. 2018; 90: 373-379.

[6] Briguori C, Visconti G, Focaccio A, Airoldi F, Valgimigli M, Sangiorgi GM, et al. Renal insufficiency after contrast media administration trial II (REMEDIAL II): RenalGuard system in high-risk patients for contrast-induced acute kidney injury. Circulation. 2011; 124: 1260-1269.

[7] Banai A, Rozenfeld K-L, Lewit D, Merdler I, Loewenstein I, Banai S, et al. Neutrophil gelatinase-associated lipocalin (NGAL) for the prediction of acute kidney injury in chronic kidney disease patients treated with primary percutaneous coronary intervention. IJC Heart and Vessels. 2021; 32: 100695.

[8] Shah R, Wood SJ, Khan SA, Chaudhry A, Rehan Khan M, Morsy MS. High-volume forced diuresis with matched hydration using the RenalGuard System to prevent contrast-induced nephropathy: a meta-analysis of randomized trials. Clinical Cardiology. 2017; 40: 1242-1246.

[9] Merdler I, Rozenfeld K, Zahler D, Shtark M, Goldiner I, Loewenstein I, et al. Neutrophil gelatinase-associated lipocalin for the early prediction of acute kidney injury in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention. Car-diorenal Medicine. 2020; 10: 154-161.

[10] Rozenfeld K, Zahler D, Shtark M, Goldiner I, Keren G, Banai S, et al. Elevated neutrophil gelatinase-associated lipocalin for the assessment of structural versus functional renal damage among ST-segment elevation myocardial infarction patients. Blood Purification. 2020; 49: 560-566.

[11] Rozenfeld K, Zahler D, Shtark M, Goldiner I, Keren G, Shacham Y. Elevated neutrophil gelatinase-associated lipocalin levels before contrast media administration among ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention. Coro-nary Artery Disease. 2020; 31: 118-123.

[12] Rodriguez R, Hasoon M, Eng M, Michalek J, Liu Q, Hernandez B, Bansal S, Bailey SR, Prasad A. Incidence and predictors of acute kidney injury following transcatheter aortic valve replacement: role of changing definitions of renal function and injury. Journal of Invasive Cardiology. 2020; 32: 138-141.

[13] Musso CG, Álvarez-Gregori J, Jauregui J, Macías-Núñez JF. Glomerular filtration rate equations: a comprehensive review. International Urology and Nephrology. 2016; 48: 1105-1110.

[14] Ma M, Gao W, Gu Y, Wang Y, Zhu Y, He Y. Clinical effects of acute kidney injury after transcatheter aortic valve implantation: a systematic review and meta-analysis. Internal and Emergency Medicine. 2019; 14: 161-175.

[15] Barbanti M, Gargiulo G, Tamburino C. Renal dysfunction and tran-scatheter aortic valve implantation outcomes. Expert Review of Cardio-vascular Therapy. 2016; 14: 1315-1323.

[16] Cao W, Cui S, Yang L, Wu C, Liu J, Yang F, et al. Contrast-enhanced ultrasound for assessing renal perfusion impairment and predicting acute kidney injury to chronic kidney disease progression. Antioxidants & Redox Signaling. 2017; 27: 1397-1411.

[17] Kashani K, Cheungpasitporn W, Ronco C. Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption. Clinical Chemistry and Laboratory Medicine. 2017; 55: 1074-1089.

[18] Schrezenmeier EV, Barasch J, Budde K, Westhoff T, Schmidt-Ott KM. Biomarkers in acute kidney injury-pathophysiological basis and clinical performance. Acta Physiologica. 2017; 219: 556-574.

[19] Shang W, Wang Z. The update of NGAL in acute kidney injury. Current Protein & Peptide Science. 2017; 18: 1211-1217.

[20] Soni SS, Cruz D, Bobek I, Chionh CY, Nalesso F, Lentini P, et al. NGAL: a biomarker of acute kidney injury and other systemic conditions. International Urology and Nephrology. 2010; 42: 141-150.

[21] de Geus HRH, Ronco C, Haase M, Jacob L, Lewington A, Vincent J. The cardiac surgery-associated neutrophil gelatinase-associated lipocalin (CSA-NGAL) score: a potential tool to monitor acute tubular damage. The Journal of Thoracic and Cardiovascular Surgery. 2016; 151: 1476-1481.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time