Biomarkers for the early prediction of contrast-induced nephropathy after percutaneous coronary intervention in adults: A systematic review and meta-analysis

Abstract

Contrast-induced nephropathy (CIN) is a complication of patients undergoing percutaneous coronary intervention (PCI). Promising biomarkers for the early prediction of CIN can significantly improve outcomes of these patients. We searched PubMed, EMBASE, Web of Science, and Cochrane Library for studies. Trials reporting an area under the curve (AUC) for the utility of novel biomarkers in the early prediction of CIN in adults after PCI were included. In total, 42 studies comprising 11,984 adult patients undergoing PCI met the criteria. Four urinary biomarkers and four blood biomarkers were included. For urine biomarkers, the pooled AUCs for neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), liver-type fatty acid-binding protein (L-FABP), and kidney injury molecule-1 (KIM-1) were 0.91 (95% CI 0.89–0.94), 0.79 (0.75–0.82), 0.78 (0.74–0.82), and 0.79 (0.76–0.83), respectively. The blood biomarkers NGAL, cystatin C, brain natriuretic peptide (BNP), and C-reactive protein (CRP) had pooled AUCs of 0.93 (0.91–0.95), 0.92 (0.89–0.94), 0.78 (0.74–0.81), and 0.75 (0.71–0.79), respectively. Subgroup analysis showed that blood NGAL in early CIN predictive time (<6 h) was more effective in predicting CIN. The efficiency of cystatin C in predicting CIN was reduced, whereas that of L-FABP was increased among chronic kidney disease (CKD) patients.

Contrast-induced acute kidney injury and its contemporary prevention

“…The meta-analysis by Yi He ( 62 ) et al and Lareyere et al ( 63 ) showed non-inferior results compared to cystatin C performance. Compared with IL-18, KIM-1, L-FABP, CRP, and BNP, NGAL exhibited increased predictive value in CI-AKI after PCI ( 64 ). However, Sharrod-Cole et al reported the utility of plasma NGAL in patients undergoing CABG as inconclusive of CI-AKI prediction ( 65 ).…”

Procalcitonin and High APACHE Scores are Associated with the Development of Acute Kidney Injury in Patients with SARS-CoV-2

“…There is evidence that AKI is a phenomenon associated with the activation of proinflammatory cytokines, and with this, it calls for the use of markers of kidney injury (27). Some biomarkers predict AKI(37); however, the high costs and lack of availability of these tests in our region forced us to use biochemical parameters that are within reach in our practice to predict AKI events. PCT is barely detectable in healthy individuals; however, diverse conditions tend to elevate it (surgery, trauma, burns, pancreatitis, and sepsis), where levels can be markedly high (38-42).…”

Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2

“…There is evidence that AKI is a phenomenon associated with the activation of proinflammatory cytokines and therefore calls for the use of markers of kidney injury [ 27 ]. Some biomarkers predict AKI [ 42 ]. However, the high cost and lack of availability of these tests in our region forced us to use biochemical parameters more within reach in our practice in order to predict AKI events.…”