Urinary Liver-Type Fatty Acid Binding Protein as a Postoperative Marker of Acute Kidney Injury in Patients Undergoing EndovascularAortic Aneurysm Repair.

OBJECTIVE

To evaluate the role of urinary liver-type fatty acid binding protein (L-FABP) in early detection of acute kidney injury (AKI) after endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA).

DESIGN

Prospective, observational, multicenter study.

SETTING

Four university hospitals from January 2024 to June 2024.

PARTICIPANTS

Fifty-nine hospitalized patients with AAA.

INTERVENTIONS: Patients undergoing EVAR were included. Demographic data, comorbidities, and renal function data were recorded at baseline and after intervention. L-FABP data were collected at baseline and at 6 hours and 24 hours after surgery.

MEASUREMENTS AND MAIN

RESULTS

The cohort had a mean age of 70.2 ± 7.3 years and was predominantly male (84.7%). Positive L-FABP results were observed in 24.1% of patients at 6 hours post-EVAR and in 23.7% at 24 hours post-EVAR. A positive L-FABP status at both time points was significantly associated with elevated postoperative serum creatinine (SCr) and reduced estimated glomerular filtration rate (eGFR) (p ≤ 0.015), reduced urine output (p = 0.009 and p < 0.001), and shorter hospital length of stay (LOS) (p = 0.004 and p = 0.013). Multivariable logistic regression analysis fully confirmed these associations. Predictive models incorporating L-FABP achieved high accuracy for identifying patients with reduced diuresis (up to 86.1%). Additionally, L-FABP at 6 hours and 24 hours predicted LOS, whereas SCr and eGFR values did not.

CONCLUSION

Urinary L-FABP is emerging as a sensitive biomarker for AKI in patients undergoing EVAR.