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Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of contrast-induced nephropathy after percutaneous coronary intervention.
Scand J Clin Lab Invest. 2014 Mar; 74(2):81-8.SJ

Abstract

BACKGROUND

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.

METHODS

Consecutive patients (n = 128), with stable coronary heart disease and eGFR ≥ 30 mL/min/1.73 m(2), 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.

RESULTS

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]; p = 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]; p < 0.001). Compared to common biomarkers, NGAL best predicted CI-AKI (AUC 0.939 [95% CI 0.89-0.99; p < 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%], p < 0.01).

CONCLUSION

Urinary NGAL is a biomarker for predicting CI-AKI when measured 1 day after PCI.

Authors+Show Affiliations

Kerckhoff Heart and Thorax Center, Department of Cardiology , Bad Nauheim.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24304491

Citation

Liebetrau, Christoph, et al. "Neutrophil Gelatinase-associated Lipocalin (NGAL) for the Early Detection of Contrast-induced Nephropathy After Percutaneous Coronary Intervention." Scandinavian Journal of Clinical and Laboratory Investigation, vol. 74, no. 2, 2014, pp. 81-8.
Liebetrau C, Gaede L, Doerr O, et al. Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of contrast-induced nephropathy after percutaneous coronary intervention. Scand J Clin Lab Invest. 2014;74(2):81-8.
Liebetrau, C., Gaede, L., Doerr, O., Blumenstein, J., Rixe, J., Teichert, O., Willmer, M., Weber, M., Rolf, A., Möllmann, H., Hamm, C., & Nef, H. (2014). Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of contrast-induced nephropathy after percutaneous coronary intervention. Scandinavian Journal of Clinical and Laboratory Investigation, 74(2), 81-8. https://doi.org/10.3109/00365513.2013.860615
Liebetrau C, et al. Neutrophil Gelatinase-associated Lipocalin (NGAL) for the Early Detection of Contrast-induced Nephropathy After Percutaneous Coronary Intervention. Scand J Clin Lab Invest. 2014;74(2):81-8. PubMed PMID: 24304491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of contrast-induced nephropathy after percutaneous coronary intervention. AU - Liebetrau,Christoph, AU - Gaede,Luise, AU - Doerr,Oliver, AU - Blumenstein,Johannes, AU - Rixe,Johannes, AU - Teichert,Olaf, AU - Willmer,Matthias, AU - Weber,Michael, AU - Rolf,Andreas, AU - Möllmann,Helge, AU - Hamm,Christian, AU - Nef,Holger, Y1 - 2013/12/05/ PY - 2013/12/6/entrez PY - 2013/12/7/pubmed PY - 2014/11/5/medline SP - 81 EP - 8 JF - Scandinavian journal of clinical and laboratory investigation JO - Scand J Clin Lab Invest VL - 74 IS - 2 N2 - BACKGROUND: 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. METHODS: Consecutive patients (n = 128), with stable coronary heart disease and eGFR ≥ 30 mL/min/1.73 m(2), 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. RESULTS: 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]; p = 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]; p < 0.001). Compared to common biomarkers, NGAL best predicted CI-AKI (AUC 0.939 [95% CI 0.89-0.99; p < 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%], p < 0.01). CONCLUSION: Urinary NGAL is a biomarker for predicting CI-AKI when measured 1 day after PCI. SN - 1502-7686 UR - https://www.unboundmedicine.com/medline/citation/24304491/Neutrophil_gelatinase_associated_lipocalin__NGAL__for_the_early_detection_of_contrast_induced_nephropathy_after_percutaneous_coronary_intervention_ DB - PRIME DP - Unbound Medicine ER -