Role of Neutrophil Gelatinase-Associated Lipocalin for Early Detection of Acute Kidney Linjury Before and After Cardiac Catheterization

Abstract

Background and objectives:Acute kidney injury develops in up to 5% of the hospitalized patients and in up to 30% patients admitted in the Intensive Care Unit. The administration of contrast media can lead to a usually reversible form of acute kidney injury called contrast-induced nephropathy. The diagnosis is based on the increase in serum creatinine, which is delayed. It is necessary to identify and validate new biomarkers that allow for early and effective interventions. We assessed the acute kidney injury in patients undergoing coronary angiography by using marker that detect early kidney injury which is urinary neutrophil gelatinase-associated lipocalin in urine. Method: In patients attending Duhok cardiac center; we checked renal function test and urinary neutrophil gelatinase-associated lipocalin before cardiac catheterization as a baseline and then we screened serum creatinine and neutrophil gelatinase- associated lipocalin in urine after 48 hours of coronary catheterization for the early detection of acute kidney injury. After 2-4 week we repeated renal function tests. Results: Hypertension is the most common risk factor for contrast induced nephropathy among our participants. Twenty-one participants (11%) develop acute kidney injury. Only one patient needed hemodialysis which was among the risky group participants. Acute kidney injury was more common with those with risk factors for contrast nephropathy. Twenty subjects of those who developed acute kidney injury (95%) were diagnosed early by urinary neutrophil gelatinase-associated lipocalin test while serum creatinine was normal at first 48 hours. Conclusions: We concluded that urinary neutrophil gelatinase-associated lipocalin is early and sensitive marker for kidney injury in comparison with serum creatinine.