Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients

Lupu, Lior; Abukatash, Hytham; Banai, Ariel; Rozenfeld, Keren-Lee; Lewit, Dana; Merdler, Ilan; Loewenstein, Itamar; Bornstein, Gil; Banai, Shmuel; Shacham, Yacov

doi:10.3390/jcm10225403

Cited by 10 publications

(6 citation statements)

References 26 publications

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“…[41 ] in terms of the selected patient cohort, including patients with different levels of renal function (GFR is in a wide range from 15 to 90 ml/min), which is also reflected in the different baseline levels of NGAL cited by the authors (360.29±227.94 ng/ml at GFR 15-30 ml /min versus 114.02±57.42 ng/ml at GFR 60-90 ml/min). Considering that the existence of chronic kidney disease affects the level of NGAL [28,54] , as well as our preliminary data in this direction [26], we turned our attention to a more strictly selected sample according to renal function, examining separately the characteristics of NGAL among patients with GFR above 60 ml/min. Breglia et al .…”

Section: Discussionmentioning

confidence: 99%

NGAL as Biomarker of Clinical and Subclinical Damage of Kidney Function after Coronary Angiography

Petrova¹,

Alexandrov²,

Vladimirov³

et al. 2023

Preprint

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Contrast-induced acute kidney injury (CI-AKI) is a serious complication after angiographic examinations in cardiology. Diagnosis may be delayed based on standard serum creatinine, and subclinical forms of kidney damage may not be detected at all. In our study we investigate the clinical use in these directions of a “damage” type biomarker - Neutrophil Gelatinase-Associated Lipocalin (NGAL). Among patients with a high-risk profile undergoing scheduled coronary angiography and/or angioplasty, plasmsa NGAL was determined at baseline, at 4 and 24 hours after contrast administration. In the CI-AKI group, NGAL increased significantly at the 4th hour (132.33±72.83 ng/ml versus 111.48±65.06 ng/ml, p=0.006) and at the 24th hour (212 .93±276.61 ng/ml, p=0.008). In patients with subclinical CI-AKI, NGAL also increased significantly at the 4th hour (128.18±99 ng/ml, p=0.002) and reached levels close to those in patients with CI-AKI. Unlike new biomarker, however, serum creatinine did not change significantly in this group. The diagnostic power of NGAL is extremely good - AUC 0.847 (95% CI: 0.677-1.000; p=0.001) in CI-AKI and AUC 0.731 (95% CI: 0.539 – 0.924; p=0.024) in subclinical CI-AKI. NGAL may be a reliable biomarker for early diagnosis of clinical and subclinical forms of renal injury after contrast angiographic studies.

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Section: Discussionmentioning

confidence: 99%

NGAL as Biomarker of Clinical and Subclinical Damage of Kidney Function after Coronary Angiography

Petrova¹,

Alexandrov²,

Vladimirov³

et al. 2023

Preprint

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“…Unlike serum creatinine, NGAL is produced by the distal nephron and rapidly released into the bloodstream, which makes NGAL a much more sensitive marker of kidney injury 31 . Studies have also pointed NGAL as an earlier marker of kidney injury than serum creatinine in various clinical settings, including in patients with normal renal function, with septic shock, or post-cardiac surgery 4 , 32 , 33 , causing NGAL to be seen as a ‘kidney troponin’ 34 . Based on these data, the Acute Dialysis Quality Initiative proposed a combination of kidney functional (i.e., serum creatinine) and structural (e.g., NGAL) damage markers to stratify the risk of acute kidney damage 30 .…”

Section: Discussionmentioning

confidence: 99%

“…Left ventricular ejection fraction on admission ≤ 45% a 4,32,33 , causing NGAL to be seen as a 'kidney troponin' 34 . Based on these data, the Acute Dialysis Quality Initiative proposed a combination of kidney functional (i.e., serum creatinine) and structural (e.g., NGAL) damage markers to stratify the risk of acute kidney damage 30 .…”

Section: Parameter or (95%ci) P-valuementioning

confidence: 99%

Neutrophil gelatinase-associated lipocalin monitoring reveals persistent subclinical kidney injury following intraarterial administration of iodinated contrast agents

Scridon

Somkereki

Nicoară

et al. 2022

Sci Rep

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Clinically overt contrast-induced nephropathy (CIN) is one of the most feared complications in patients exposed to iodinated contrast media and has been extensively studied over the years. Meanwhile, the incidence and evolution of subclinical contrast-induced kidney injury remain elusive. With the continuous increase in the number of patients that are repeatedly exposed to contrast media, elucidating these issues is of critical importance. Accordingly, we aimed to evaluate the incidence and the evolution of clinical and subclinical kidney injury in patients exposed to contrast media. A total of 178 patients who underwent elective percutaneous angioplasty procedures were evaluated prospectively. Serum creatinine and neutrophil gelatinase-associated lipocalin (NGAL) levels were evaluated pre-procedurally, 48 h and 1 month after administration of contrast media. The evolution of creatinine and NGAL levels was analyzed at the three time points, and the potential predictors of contrast-induced clinical and subclinical renal injury were evaluated. Clinically overt CIN occurred in 10 (5.6%) patients. Baseline serum creatinine and the volume of contrast media were the only independent predictors of CIN and in all 10 patients creatinine levels returned to baseline by 1 month (p = 0.32). Subclinical contrast-induced kidney injury was much more common, affecting 32 (17.9%) patients, was only predicted by the baseline serum creatinine, and persisted in 53.1% of patients after 1 month. This study showed that whereas clinically overt CIN is rather rare and regressive, subclinical contrast-induced kidney injury is considerably more frequent, affecting almost 18% of patients that receive intraarterial contrast media. More importantly, subclinical kidney injury persisted after 1 month in more than 50% of the initially affected patients, who may thus be at increased risk for further renal impairment, particularly if exposed to nephrotoxic agents or repeated administration of contrast media.

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“…29 Unlike serum creatinine, NGAL is speci cally produced by the distal nephron and rapidly released into the bloodstream, which makes NGAL a much more sensitive marker of kidney injury. 30 Studies have also pointed NGAL as an earlier marker of kidney injury than serum creatinine in various clinical settings, including in patients with normal renal function, with septic shock, or postcardiac surgery, 4,31,32 causing NGAL to be seen as a 'kidney troponin'. 33 Based on these data, the Acute Dialysis Quality Initiative proposed a combination of kidney functional (i.e., serum creatinine) and structural (e.g., NGAL) damage markers to stratify the risk of acute kidney damage.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil gelatinase-associated lipocalin monitoring reveals persistent subclinical kidney injury following intraarterial administration of iodinated contrast agents

Scridon,

Somkereki,

Nicoară

et al. 2022

Preprint

View full text Add to dashboard Cite

Background Clinically overt contrast-induced nephropathy (CIN) is one of the most feared complications in patients exposed to iodinated contrast media and has been extensively studied over the years. Meanwhile, the incidence and evolution of subclinical contrast-induced kidney injury remain elusive. With the continuous increase in the number of patients that are repeatedly exposed to contrast media, elucidating these issues is of critical importance. Accordingly, we aimed to evaluate the incidence and the evolution of clinical and subclinical kidney injury in patients exposed to contrast media. Methods A total of 178 patients who underwent elective percutaneous angioplasty procedures were evaluated prospectively. Serum creatinine and neutrophil gelatinase-associated lipocalin (NGAL) levels were evaluated pre-procedurally, 48 hours and 1 month after administration of contrast media. The evolution of creatinine and NGAL levels was analyzed at the three time points, and the potential predictors of contrast-induced clinical and subclinical renal injury were evaluated. Results Clinically overt CIN occurred in 10 (5.6%) patients. Baseline serum creatinine and the volume of contrast media were the only independent predictors of CIN and in all 10 patients creatinine levels returned to baseline by 1 month (p = 0.32). Subclinical contrast-induced kidney injury was much more common, affecting 32 (17.9%) patients, was only predicted by the baseline serum creatinine, and persisted in 53.1% of patients after one month. Conclusions This study showed that whereas clinically overt CIN is rather rare and regressive, subclinical contrast-induced kidney injury is considerably more frequent, affecting almost 18% of patients that receive intraarterial contrast media. More importantly, subclinical kidney injury persisted after 1 month in more than 50% of the initially affected patients, who may thus be at increased risk for further renal impairment, particularly if exposed to nephrotoxic agents or repeated administration of contrast media.

show abstract

Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients

Cited by 10 publications

References 26 publications

NGAL as Biomarker of Clinical and Subclinical Damage of Kidney Function after Coronary Angiography

NGAL as Biomarker of Clinical and Subclinical Damage of Kidney Function after Coronary Angiography

Neutrophil gelatinase-associated lipocalin monitoring reveals persistent subclinical kidney injury following intraarterial administration of iodinated contrast agents

Neutrophil gelatinase-associated lipocalin monitoring reveals persistent subclinical kidney injury following intraarterial administration of iodinated contrast agents

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