What question did this study set out to answer?

To investigate the relationship between intraoperative hypotension and acute kidney injury (AKI) measured by plasma NGAL in pediatric spine surgery.

March 5, 2026BMC Nephrology0 citationsOpen Access

Plasma NGAL-detected kidney injury following paediatric spine surgery: role of intraoperative hypotension

SASeymanur AltintasSağlık Bilimleri Üniversitesi GBGülşen BosnaHaydarpaşa Numune Eğitim ve Araştırma Hastanesi OEO. B. EkinciHaydarpaşa Numune Eğitim ve Araştırma Hastanesi

Key Points

To investigate the relationship between intraoperative hypotension and acute kidney injury (AKI) measured by plasma NGAL in pediatric spine surgery.
Observational analysis of children undergoing spine surgery.
Measurement of plasma NGAL levels at 6 hours post-surgery.
Assessment of intraoperative mean arterial pressure (MAP) and its relationship to AKI.
12% of children exhibited clinical AKI post-surgery.
One-third had subclinical AKI detectable via NGAL.
MAP < 70 mmHg was associated with tubular damage, and MAP < 60 mmHg correlated with clinical AKI.

Abstract

Although 12% of the children developed clinical AKI, approximately one-third had subclinical AKI detectable only by NGAL. Plasma NGAL at the 6th hour demonstrated excellent sensitivity for predicting AKI, with a threshold of 86 ng/mL. Intraoperative hypotension was a major predictor, with a MAP < 70 mmHg linked to tubular damage whereas deeper hypotension (MAP < 60 mmHg) was linked to clinical AKI. This study is the first to define NGAL cut-off values and intraoperative MAP thresholds for postoperative AKI in paediatric non-cardiac surgery.

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