{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T22:59:49Z","timestamp":1756076389560,"version":"3.40.5"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"crossref","award":["2017\/27032-0"],"award-info":[{"award-number":["2017\/27032-0"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Increased intra-abdominal pressure causes hemodynamic changes that may affect renal biomarkers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>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 (P<jats:sub>10-12<\/jats:sub>, 10\u201312 mm Hg) and a low intra-abdominal pressure group (P<jats:sub>6-8<\/jats:sub>, 6\u20138 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 &lt; 0.05 were considered statistically significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In total, 64 patients completed the study\u201433 were given standard pressure and 31 were given low pressure. There was no significant difference in the biomarker between the groups (<jats:italic>P<\/jats:italic> = 0.580), but there was a significant difference between the time points with elevation at T1 (<jats:italic>P<\/jats:italic> &lt; 0.001). Similar to NGAL, cystatin C had an elevation at T1 in both groups (<jats:italic>P<\/jats:italic> = 0.021), but no difference was found when comparing the groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0247088","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T03:31:58Z","timestamp":1613791918000},"page":"e0247088","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of pneumoperitoneum on kidney injury biomarkers: A randomized clinical 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