Cystatin C, but not urinary or serum NGAL, may be associated with contrast induced nephropathy after

Cecchi, Emanuele; Avveduto, Gianfranco; DʼAlfonso, Maria Grazia; Terreni, Alessandro; Gelera, Emma; Caldini, Anna; Giglioli, Cristina

doi:10.5644/ama2006-124.184

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…It has been repeatedly described as an early diagnostic marker after contrast application, but data on its predictive value for CI-AKI is available only from a few very small trials with conflicting results. [22][23][24] In the present study it proved the best prognostic accuracy of the investigated urinary biomarkers with a high negative predictive value. Thus, an NGAL/creatinine concentration < 56.4 μg/mg precludes the occurrence of CI-AKI with a 96.5% probability.…”

Section: Plos Onesupporting

confidence: 72%

“…Whereas NGAL and KIM-1 have been investigated in this context in smaller studies before, calprotectin was examined for the first time. [ 22 – 24 ] Since these biomarkers are able to detect subclinical tubular injury, it appeared reasonable that they could contribute to the risk assessment of CI-AKI, especially in those subjects without clinically overt CKD. Indeed, urinary NGAL/creatinine ratios were 3.1 times and thereby significantly higher in those subjects, who later developed CI-AKI.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas NGAL and KIM-1 have been investigated in this context in smaller studies before, calprotectin was examined for the first time. [22][23][24] Since these biomarkers are able to detect subclinical tubular injury, it…”

Section: Discussionmentioning

confidence: 99%

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Biomarkers in the prediction of contrast media induced nephropathy – the BITCOIN study

et al. 2020

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Background Subjects with chronic kidney disease are at increased risk for contrast-induced acute kidney injury (CI-AKI). Risk stratification is traditionally based on glomerular filtration rate (GFR) and proteinuria. The present trial examines, whether tubular and inflammatory biomarkers are able to identify subjects at increased risk as well. Methods We performed a prospective study in 490 patients undergoing coronary angiography. An increase of serum creatinine concentration ≥ 0.3 mg/dl from baseline to day 2–3 was defined as primary endpoint (CI-AKI). Urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and calprotectin were assessed < 24h before coronary angiography. Prognostic accuracy was assessed by receiver operating characteristics (ROC) calculations. Results 30 (6.1%) patients suffered from CI-AKI (27 AKIN stage I, 3 AKIN stage II, 0 AKIN stage III). Those subjects who developed CI-AKI had 3.1 fold higher baseline urinary NGAL/creatinine ratios than those without CI-AKI (60.8 [IQR 18.7–93.1] μg/mg vs. 19.9 [IQR 12.3–38.9] μg/mg, p = 0.001). In those subjects without clinically overt CKD (eGFR > 60 ml/min, urinary albumin creatinine ratio <30 mg/g), the NGAL/creatinine ratio was 2.6 higher in CI-AKI vs. no CI-AKI (47.8 [IQR 11.8–75.3] vs. 18.6 [IQR 11.7–36.3] μg/mg). No significant differences were obtained for KIM-1 and calprotectin (p>0.05 each). ROC analyses revealed an area under the curve (AUC) of 0.68 (95% CI 0.60–0.81) for NGAL/creatinine. An NGAL/creatinine ratio < 56.4 μg/mg has a negative predictive value of 96.5%. Conclusions The present study is the largest investigation on the use of urinary biomarkers for CI-AKI risk stratification so far. It shows that NGAL provides prognostic information beyond the glomerular biomarkers eGFR and proteinuria.

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Section: Plos Onesupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Biomarkers in the prediction of contrast media induced nephropathy – the BITCOIN study

et al. 2020

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“…Xie et al reported that CIN was diagnosed 24 h earlier by serum NGAL and Cys-C levels than by SCr level 20 . However, Cecchi et al found that the serum and urine NGAL levels in elderly patients after PCI barely increased, whereas Cys-C level significantly rose 21 . The results of this study demonstrated that AUCs of serum NGAL and Cys-C levels were highest 6, 12 and 24 h after PCI, so Cys-C was an ideal index for the early diagnosis of CIN.…”

Section: Discussionmentioning

confidence: 97%

Values of serum neutrophil gelatinase-associated lipocalin and cystatin C after percutaneous coronary intervention for early diagnosis of contrast-induced nephropathy

Luo,

Ao,

Xiang

et al. 2023

Afr H. Sci.

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Objective: Serum creatinine (SCr) is not a sensitive and reliable index for the early diagnosis of acute kidney injury caused bycontrast-induced nephropathy (CIN). The aim of this study was to explore the values of serum neutrophil gelatinase-associatedlipocalin (NGAL) and cystatin C (Cys-C) after percutaneous coronary intervention (PCI) for the early diagnosis of CIN. Methods: Three hundred patients receiving PCI from January 2018 to December 2020 were assigned to a CIN group (n=25)and a non-CIN group (n=275), respectively. SCr, Cys-C and NGAL levels were measured, and their sensitivities for early CINdiagnosis were evaluated by the area under the receiver operating characteristic curve (AUC) values. Results: The NGAL and Cys-C levels of the CIN group began to rise 6 and 12 h after operation, respectively (P<0.05). TheCIN group had higher NGAL and Cys-C levels than those of the non-CIN group 12, 24 and 48 h after operation (P<0.05). TheAUC values of NGAL, Cys-C and SCr 24 h after operation were 0.885, 0.874 and 0.856, respectively. Conclusion: The serum NGAL and Cys-C levels of patients after PCI reflect the early changes of renal function, which arevaluable for early CIN diagnosis. Keywords: Contrast; cystatin C; nephropathy; neutrophil gelatinase-associated lipocalin; percutaneous coronary intervention.

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“…activated by neutrophils as an acute-phase protein, which constitutes important confounders. Cecchi E et al [31] demonstrated that serum cystatin C was associated with serum creatinine and the occurrence of CIN in patients undergoing percutaneous coronary invasive procedures (PCIPs). The rise in NGAL may suggest injury not only from the kidney but also from acute/ chronic inflammation, especially in patients in intensive care settings.…”

Section: Plos Onementioning

confidence: 99%

Predictive value of cystatin C and neutrophil gelatinase-associated lipocalin in contrast-induced nephropathy: A meta-analysis

Deng

Zhuang

et al. 2020

PLoS ONE

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Background There are still limited studies comprehensively examining the diagnostic performance of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in contrast-induced nephropathy (CIN). The study aimed to investigate and compare the predictive value of NGAL and cystatin C in the early diagnosis of CIN. Methods and materials We searched the PubMed, EMBASE and Cochrane Library databases until November 10, 2019. The methodological quality of the included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Bivariate modeling and hierarchical summary receiver operating characteristic (HSROC) modeling were performed to summarize and compare the diagnostic performance of blood/urine NGAL and serum cystatin C in CIN. Subgroup and meta-regression analyses were performed according to the study and patient characteristics. Results Thirty-seven studies from thirty-one original studies were included (blood NGAL, 1840 patients in 9 studies; urine NGAL, 1701 patients in 10 studies; serum cystatin C, 5509 patients in 18 studies). Overall, serum cystatin C performed better than serum/urine NGAL (pooled DOR: 43 (95%CI: 12-152); AUROC: 0.93; λ: 3.79); serum and urine NGAL had a similar diagnostic performance (pooled DOR: 25 (95%CI: 6-108)/22(95%CI: 8-64); AUROC: 0.90/0.89; λ: 3.20/3.08). Meta-regression analysis indicated that the sources of heterogeneity might be CIN definition, assays, and nationalities. Conclusion Both NGAL and cystatin C can serve as early diagnostic indicators of CIN, while cystatin C may perform better than NGAL.

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Cystatin C, but not urinary or serum NGAL, may be associated with contrast induced nephropathy after

Cited by 7 publications

References 33 publications

Biomarkers in the prediction of contrast media induced nephropathy – the BITCOIN study

Biomarkers in the prediction of contrast media induced nephropathy – the BITCOIN study

Values of serum neutrophil gelatinase-associated lipocalin and cystatin C after percutaneous coronary intervention for early diagnosis of contrast-induced nephropathy

Predictive value of cystatin C and neutrophil gelatinase-associated lipocalin in contrast-induced nephropathy: A meta-analysis

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