***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Experimentally , erythropoietin ( EPO ) has nephroprotective as well as immunomodulatory properties when administered after ischemic renal injury . We tested the hypothesis that different doses of recombinant human EPO administered to patients after cardiac surgery would minimize kidney lesions and the systemic inflammatory response , thereby decreasing acute kidney injury ( AKI ) incidence . Methods In this double-blinded r and omized control study , 80 patients admitted to the ICU post-cardiac surgery were r and omized by computer to receive intravenously isotonic saline ( n = 40 ) versus α-Epoetin ( n = 40 ) : either 40000 IU ( n = 20 ) or 20000 IU ( n = 20 ) . The study lasted one year . The primary outcome was the change in urinary NGAL concentration from baseline and 48 h after EPO injection . Creatinine , cystatine C and urinary NGAL levels were measured on the day of r and omization and 2–4 days after EPO injection . To assess acute inflammatory response , serum cytokines ( IL6 and IL8 ) were measured at r and omization and four days after r-HuEPO injection . Patients and care-takers were blinded for the assignment . Results No patient was excluded after r and omization . Patient groups did not differ in terms of age , gender , comorbidities and renal function  at r and omization . The rate of AKI assessed by AKIN criteria was 22.5 % in our population  . EPO treatment did not significantly modify the difference in uNGAl between 48 hours and r and omization compared to placebo [ 2.5 ng/ml ( −17.3 ; 22.5 ) vs 0.7 ng/ml ( −31.77 ; 25.15 ) , p = 0.77 ] and the incidence of AKI was similar . Inflammatory cytokines levels were not influenced by EPO treatment . Mortality and hospital stays were similar between the groups and no adverse event was recorded . Conclusion In this r and omized-controlled trial , α-Epoetin administrated after cardiac surgery , although safe , demonstrated neither nephroprotective nor anti-inflammatory properties . Trial registration PURPOSE To evaluate the effect of parecoxib ( an NSAID ) on renal function by measuring plasma NGAL ( serum neutrophil gelatinase-associated lipocalin ) levels in an induced-ischemia rat model . METHODS Forty male Wistar rats were r and omly assigned to one of four groups : Ischemia ( I ) , Ischemia/parecoxib ( IP ) , No-ischemia ( NI ) , and No-ischemia/parecoxib ( NIP ) . Body weight , mean arterial pressure , heart rate , body temperature , NGAL levels , and renal histology were compared across groups . RESULTS The Ischemia ( I ) group , which did not receive parecoxib , showed the highest NGAL levels ( p=0.001 ) , while the IP group , which received the medication , had NGAL levels similar to those of the non-ischemic ( NI and NIP ) groups . CONCLUSION Parecoxib result ed in renal protection in this experimental model INTRODUCTION Delayed graft function ( DGF ) is a consequence of ischemia-reperfusion injuries in kidney allografts , for which no definite treatment is available . The neutrophil gelatinase-associated lipocalin ( NGAL ) and interleukin-18 ( IL-18 ) are introduced as the most promising urine biomarkers to detect DGF . N-acetylcysteine ( NAC ) and vitamin C , well-known potent antioxidants that scavenge free radicals , may alleviate kidney injury . This study investigated the protective effects of NAC alone and in combination with vitamin C on DGF , by measuring IL-18 and NGAL in living donor kidney transplantations . MATERIAL S AND METHODS Patients transplanted between January 2011 and February 2013 were r and omly divided into 3 groups to receive  routine anti-rejection medication only  ( n = 32 ) , NAC plus routine immunosuppressive regimen  ( NAC group ; n = 33 ) , and NAC and vitamin C plus routine regimen ( NAC and vitamin C group ; n = 19 ) . Urine sample s were taken 4 hours and 24 hours after transplantation . Enzyme-linked immunosorbent assay kits were utilized for measuring urine NGAL and IL-18 . RESULTS There were no significant differences in the DGF prevalence and its duration between the study arms . Although the levels of NGAL and IL-18 decreased in the NAC and NAC and vitamin C groups , these reductions were not significant . Glomerular filtration rate at 30 and 60 days after transplantation were not significantly different between study groups , either . CONCLUSIONS Our results showed that NAC is a safe drug without significant adverse effects in kidney transplant recipients ; however , its potential useful effects on urinary biomarkers of DGF were not illustrated in the present study Background : Use of aprotinin has been associated with acute kidney injury after cardiac surgery . Neutrophil gelatinase-associated lipocalin ( NGAL ) is a novel , very sensitive marker for renal injury . Urinary NGAL may be able to detect renal injury caused by aprotinin . This study determined if the use of aprotinin is associated with an increased incidence of acute kidney injury and increased levels of urinary NGAL . Methods : In this prospect i ve , observational study 369 patients undergoing cardiac surgery were enrolled . 205 patients received aprotinin and 164 received epsilon amino-caproic acid intraoperatively .  Urinary NGAL was measured before and immediately after cardiac surgery and 3 , 18 and 24 h later . The association of aprotinin use with the incidence of acute kidney injury ( increase of serum creatinine > 0.5 mg/dl ) and NGAL levels was determined using logistic and linear regression models . Results : 51 of 205 patients ( 25 % ) who received aprotinin developed acute kidney injury compared to 19 of 164 patients ( 12 % ) who received epsilon amino-caproic acid ( p = 0.0013 ) . Aprotinin use was associated with a two-fold higher risk of acute kidney injury when adjusted for potential confounders ( age , Parsonnet score , preoperative serum creatinine , cardiopulmonary bypass and cross-clamp times ; multiple logistic regression : OR = 2.164 ; CI ( 95 % ) = 1.102 to 4.249 ; p = 0.0249 . Urinary NGAL was 19 times higher immediately after cardiopulmonary bypass and 18 times higher 3 h later in patients who had received aprotinin ( postoperative : 19.23 ; CI ( 95 % ) = 12.60 to 29.33 ; p < 0.0001 ; 3 h post-cardiopulmonary bypass 18.67 ; CI ( 95 % ) = 11.45 to 30.43 ; p < 0.0001 ) . Conclusions : Postoperative urinary NGAL – a novel marker for renal injury – is increased in cardiac surgical patients receiving aprotinin compared to patients receiving epsilon amino-caproic acid . These results further support the hypothesis that aprotinin may cause renal injury . The substantial rise of urinary NGAL associated with aprotinin use may in part be due to aprotinin blocking the uptake of NGAL by megalin/gp330 receptors in the proximal tubules High-dose ibuprofen ( IBU ) may slow the decline of lung function in patients with cystic fibrosis ( CF ) , but its use has been limited due to concerns over renal and gastrointestinal toxicity . In this pilot study , we examined the association of IBU with markers of acute kidney injury ( AKI ) in patients with CF . The effect of aminoglycoside ( AG ) exposure on AKI biomarkers was also examined . The AKI markers , kidney injury molecule-1 ( KIM ) , N-acetyl-β-glucosaminidase ( NAG ) and urine protein , normalized for creatinine , were chosen as they are more sensitive indicators of kidney injury than changes in serum creatinine . Urine sample s from 52 patients , 26 from patients who were treated with IBU  , were analyzed . There was no significant association between IBU treatment and KIM-1 , NAG or protein levels , compared to patients never treated with IBU . While there was an association between AG courses and KIM-1 levels , there were no differences in biomarker levels  between IBU and non-IBU groups with respect to AG courses . These preliminary results suggest that IBU treatment in patients with CF may be safe with respect to renal toxicity Acute kidney injury ( AKI ) is a frequent complication of cardiac surgery and usually occurs in patients with preexisting chronic kidney disease ( CKD ) .  Remote ischemic preconditioning ( RIPC ) may mitigate the renal ischemia-reperfusion injury associated with cardiac surgery and may be a preventive strategy for postsurgical AKI . We undertook a r and omized controlled trial of RIPC to prevent AKI in 86 patients with CKD ( estimated glomerular filtration rate under 60 ml/min per 1.73 m(2 ) ) undergoing coronary artery bypass graft ( CABG ) surgery . Forty-three patients each were r and omized to receive st and ard care with or without RIPC consisting of three 5-minute cycles of forearm ischemia followed by reperfusion . The primary end point was the development of AKI defined as an increase in serum creatinine concentration over 0.3 mg/dl within 48 h of surgery . Secondary end points included a comparison between the study and control groups of several serum biomarkers of renal injury including cystatin-C , neutrophil gelatinase-associated lipocalin ( NGAL ) , and interleukin-18 ( IL-18 ) , and urinary biomarkers including NGAL , IL-18 , and kidney injury molecule-1 measured at 6 , 12 , and 24 h after CABG , and the 72-h serum troponin T concentration area under the curve as a marker of myocardial injury . Clinical and operative characteristics were similar between the preconditioned and control groups . AKI developed in 12 patients in both groups within 48 h of CABG . There were no significant differences between the two groups in the concentrations of any of the serum or urinary biomarkers of renal or cardiac injury after CABG . Thus , RIPC induced by forearm ischemia-reperfusion had no effect on the frequency of AKI after CABG in patients with CKD PURPOSE The main objective of this study was to compare the effect of two anaesthetic techniques ( general vs combined ) on plasma levels of NGAL ( Neutrophil Gelatinase Associated Lipocalin ) after  robotic urogenital oncosurgery .  The secondary objective was to correlate NGAL levels with the incidence of acute kidney injury ( AKI ) . METHODS This was a longitudinal prospect i ve study . Forty patients were included and r and omized in 2 groups : group C ( N=16 cases ; combined general-epidural anesthesia ) and group G ( N=24 cases ; control group with general anesthesia ) .  Demographic data , Charlson Comorbidity Index , Apache II , SOFA and ASA scores were similar in both groups . Serum creatinine was determined preoperatively and every 24 hrs for 4 postoperative days to identify AKI according to RIFLE and AKIN criteria . Serum NGAL was determined at 6 and 12 hrs after induction of anesthesia . RESULTS Serum creatinine increased at 24 hrs postoperatively in both groups as compared to baseline , but significant changes were registered only in the G group ( p(control ) = 0.004 ) . Serum NGAL increased significantly in both groups as compared with baseline levels ( pcase=0.0034 vs p(control)=0.0001 ) . The incidence of AKI was 12.50 % ( 95 % CI 0.4 - 34 ) in the C group and 37.50 % ( 95 % CI 17 - 58 ) in the G group ( p=0.0909 ) , respectively . CONCLUSION Impaired renal function and AKI occurred in  robot-assisted laparoscopic urogenital oncosurgery under both general and combined anaesthesia . The incidence of AKI was lower in patients undergoing combined anesthesia compared to  general anaesthesia  after robotic urogenital oncosurgery but the difference did not reach statistical significance . However , plasma levels of NGAL were significantly increased at 6 and 12 hrs in the general anaesthesia group as compared with combined anaesthesia .  NGAL may be a better marker in detecting postoperative acute kidney injury . Further studies are needed The prevalence of type 1 cardiorenal syndrome ( CRS ) is increasing and strongly associated with long-term mortality . However , lack of reliable animal models and well-defined measures of renoprotection , made early diagnosis and therapy difficult . We previously successfully established the swine acute myocardial infa rct ion ( AMI ) model of ischemia-reperfusion by blocking left anterior descending branch ( LAD ) . Reperfusion was performed after 90-minute occlusion of the LAD . AMI was confirmed by ECG and left ventricular 
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Conclusion Differences between clinical and pre clinical studies are evident and may affect the translation of pre clinical findings in the clinical setting