The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

Abstract

Contrast-induced nephropathy (CIN) is acute kidney failure that occurs after exposure to contrast agent. There is no sensitive biomarker to predict the development of CIN. In a retrospective study, we investigated the predictive value of the fibrinogen to albumin ratio (FAR) to determine the risk of CIN in patients (N = 246) who underwent carotid angiography. Contrast-induced nephropathy was defined as a 0.5 mg/dL or 25% increase in serum creatinine levels 48 to 72 hours following exposure to a radiocontrast agent. Patients were grouped according to whether they developed CIN or not, that is, CIN(–) and CIN(+) groups, respectively. Contrast-induced nephropathy developed in 39 (15.8%) of all the patients. The fibrinogen levels, neutrophil to lymphocyte ratio (NLR), and FAR in the CIN (+) group were higher than in the CIN (−) group ( P < .001). Multivariate analysis showed that age, diabetes, NLR, platelet–lymphocyte ratio, and FAR were independent risk factors for CIN. The area under the curve (AUC) of FAR was 0.800 for the prediction of CIN, and the best cutoff value was 57.4 with sensitivity, specificity, positive predictive value, and negative predictive value of 74.4%, 60.8%, 26.4%, and 92.7%, respectively. The FAR may be useful as a predictor of CIN.

Preoperative Serum Fibrinogen is Associated With Acute Kidney Injury after Cardiac Valve Replacement Surgery

“…Fibrinogen is recognized as an acute-phase response protein, and it increases several-fold during inflammation or tissue damage 15 . Several studies have found that serum or urinary fibrinogen is associated with contrast-induced nephropathy 16 and sepsis-associated AKI 17 .…”

Serum Osmolarity and Contrast-Induced Nephropathy

“…10 Many available biomarkers such as homocysteine, procalcitonin, high-sensitivity C-reactive protein, N-terminal pro-brain natriuretic peptide, red cell distribution width, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to highdensity lipoprotein ratio, and fibrinogen to albumin ratio (FAR) have been shown to predict CIN development. [11][12][13][14][15][16][17][18][19] In the study by Yildiz et al, 1 serum osmolarity, hemoglobin, contrast media volume, creatinine on admission, basal SYNergy between PCI with TAXus and cardiac surgery II score, and left ventricular ejection fraction were found to be independent predictors of CIN. However, serum osmolarity only had a modest predictive accuracy for CIN in this analysis.…”

Is It Possible to Predict Contrast-Induced Nephropathy With Single Parameter or Ratio? Better to Include Easily Available Indices

“…We read with interest the article entitled "The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography." 1 The authors concluded that an elevated preprocedural fibrinogen to albumin ratio could be associated with the development of contrast-induced nephropathy (CIN) in patients undergoing carotid angiography. 1 Contrast-induced nephropathy is an important complication after angiography.…”

“…1 The authors concluded that an elevated preprocedural fibrinogen to albumin ratio could be associated with the development of contrast-induced nephropathy (CIN) in patients undergoing carotid angiography. 1 Contrast-induced nephropathy is an important complication after angiography. Contrast-induced nephropathy is associated with extended hospital stay, increased costs, and more shortand long-term morbidity and mortality in patients with cardiovascular disease (CVD).…”

“…4 Many easily available inflammatory and oxidative biomarkers including red cell distribution width (RDW), monocyte to high-density lipoprotein cholesterol (MHR), serum total bilirubin, uric acid, C-reactive protein (CRP), and CRP/albumin ratio have been demonstrated to be independent risk factors and novel prognostic markers for CIN and cardiovascular events as well as extent, severity, and complexity of coronary artery disease determined by the SYNTAX score. [5][6][7][8][9][10] In the study by Ertas et al, 1 there is no information regarding easily available hematological and biochemical parameters such as CRP, CRP/albumin ratio, RDW, lymphocyte count, MHR, bilirubin, and uric acid. In addition, there is no information regarding the presence or severity of coronary artery disease in the study population.…”