Predict value of monitoring changes of urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 after coronary angiography and percutaneous coronary intervention on early diagnosis of contrast-induced nephropathy
10.3760/cma.j.issn.0253-3758.2014.04.008
- VernacularTitle:冠状动脉介入诊疗术后尿中性粒细胞明胶酶相关性载脂蛋白和肾损伤分子1水平的变化及早期预测对比剂肾病的价值
- Author:
Lei WANG
1
;
Xiaoqun PU
Author Information
1. 411100,湘潭市中心医院心内三科
- Keywords:
Nephrosis;
Contrast media;
Forecasting
- From:
Chinese Journal of Cardiology
2014;42(4):301-304
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predict value of monitoring changes of urinary neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) after coronary angiography (CAG) and percutaneous coronary intervention (PCI) on the early diagnosis of contrast-induced nephropathy (CIN).Methods One hundred and sixty patients underwent CAG and PCI were enrolled in this prospective study.There were 14 patients with CIN and non-CIN patients were selected with the proportion of 2∶1 (n =28).Serum creatinine (SCr) was measured before and at 24,48 and 72 h after the procedure.Urinary NGAL and KIM-1 were measured before and at 4 and 24 h after the procedure.The relationship between NGAL,KIM-1 and CIN were analyzed.Receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to analyze the diagnostic sensitivity and specificity of CIN by urinary NGAL and KIM-1.Results (1) The values of urinary NGAL was significantly higher in the CIN group than in non-CIN group at 4 h after CAG or PCI (P ＜ 0.01) ; the value of urinary NGAL was significantly increased from the baseline to 4 h after the procedure in the CIN group(P ＜ 0.01).(2) Uurinary KIM-1 levels of CIN group was significantly higher than in non-CIN group at 24 h after the CAG or PCI(P ＜0.01) ; the urinary KIM-1 levels was significantly increased from baseline to 24 h after the procedure in the CIN group(P ＜ 0.01).(3)Pearson correlation analysis showed that there was a positive correlation between urinary NGAL and SCr (r =0.814,P ＜ 0.01) and urinary KIM-1 (r =0.758,P ＜ 0.01) in the CIN group.(4) ROC curve analysis showed that the AUC for urinary NGAL was 0.897.When the cut-off value of NGAL was set at 11.950 μg/L,the sensitivity and specificity for the diagnosis of CIN were 92.9％ and 71.4％,respectively.The AUC for urinary KIM-1 was 0.839.With the cut-off value of urinary KIM-1 set as 4.595 μg/L,the diagnostic sensitivity and specificity for CIN were 85.7％ and 71.4％,respectively.Conclusions Urinary NGAL serves as a good biomarker for early diagnosis of CIN suggesting acute kidney injury at 4 h post CAG and PCI.Urinary KIM-1 can reflect the change of renal function after contrast injection earlier than SCr and may also be a good biomarker for early diagnosis of CIN.
