Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of contrast-induced nephropathy after percutaneous coronary intervention. (March 2014)

• Record Type: Journal Article
• Authors: Liebetrau, Christoph; Gaede, Luise; Doerr, Oliver; Blumenstein, Johannes; Rixe, Johannes; Teichert, Olaf; Willmer, Matthias; Weber, Michael; Rolf, Andreas; Möllmann, Helge; Hamm, Christian; Nef, Holger
• Is Part Of: Scandinavian journal of clinical & laboratory investigation. Volume 74:Number 2(2014)
• Page Start: 81
• Page End: 88
• Publication Date: 2014-03
• Subjects: Clinical biochemistry -- Periodicals; Physiology, Pathological -- Periodicals; Physiology, Experimental -- Periodicals; Medicine -- Research -- Periodicals; Clinical medicine -- Periodicals; 616.0072
• DOI: 10.3109/00365513.2013.860615
• Languages: English
• ISSNs: 0036-5513

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Background</italic>.</bold> Contrast-induced acute kidney injury (CI-AKI) occurs in up to 13% of patients undergoing percutaneous coronary intervention (PCI). Neutrophil gelatinase-associated lipocalin (NGAL) is an early biomarker for renal impairment. We investigated whether increased urinary NGAL concentrations were predictive of CI-AKI within 2 days after PCI or of a higher re-hospitalization rate within 9 months. <bold><italic>Methods</italic>.</bold> Consecutive patients (<italic>n = </italic>128), with stable coronary heart disease and eGFR ≥ 30 mL/min/1.73 m<sup>2</sup>, undergoing PCI were included. Venous serum samples for measurement of creatinine, blood urea nitrogen, and cystatin C and urine samples for NGAL measurement were collected 4 hours and 1 and 2 days after contrast medium application. Patients were followed over 9 months to determine clinical endpoints. <bold><italic>Results</italic>.</bold> CI-AKI was observed in 14 patients (10.9%) after PCI. NGAL concentrations before PCI were significantly higher in patients with subsequent CI-AKI (19.8 ng/mL [14.4–35.8] vs. 11.6 ng/mL [5.6–28.2]; <italic>p = </italic>0.04). There was no significant difference in NGAL concentrations 4 h after PCI between patients with and without CI-AKI. One day after PCI, NGAL concentrations were significant higher in patients developing CI-AKI (100.1 ng/mL [41.5–129.2] vs. 16.6 ng/mL [9.1–28.1]; <italic>p</italic> < 0.001). Compared to common biomarkers, NGAL best predicted CI-AKI (AUC 0.939 [95% CI 0.89–0.99; <italic>p</italic> < 0.001]). The re-hospitalization rate due to progressive renal insufficiency within 9 months was higher in the group with CI-AKI than the group without (4 [28.6%] vs. 4 [3.5%], <italic>p</italic> < 0.01). <bold><italic>Conclusion</italic>.</bold> Urinary NGAL is a biomarker for predicting CI-AKI when measured 1 day after PCI.</p> </abstract>