Urinary neutrophil gelatinase‐associated lipocalin predicted to contrast‐associated acute kidney injury after planned percutaneous coronary intervention in elderly patients

Abstract

Aim To determine the proportion of contrast‐associated acute kidney injury (CA‐AKI) after percutaneous coronary intervention (PCI) and the predictive value of urine neutrophil gelatinase‐associated lipocalin (uNGAL) for CA‐AKI in elderly patients with chronic coronary artery disease. Methods A total of 509 patients who had planned percutaneous coronary intervention (mean age was 63.58 ± 11.63 years and 63.3% of males) were divided into two groups: group 1 (n = 153; elderly patients) with ≥70 years old and group 2 (n = 356) with <70 years old. Urine NGAL was measured by the ELISA method. Clinical and laboratory data were collected on the day before intervention. CA‐AKI was defined based on Kidney Disease: Improving Global Outcomes criteria. Results The ratio of CA‐AKI in group 1 was 23.5% which was higher than that of group 2 (8.7%) with a p‐value < 0.001. Urine NGAL level in group 1 was significantly higher than that of group 2 [31.3 (19.16–55.13) ng/ml vs. 19.86 (13.21–29.04) ng/ml, p < 0.001]. At a cut‐off value of 44.43 ng/ml, uNGAL had a predictive value for CA‐AKI in all patients (AUC = 0.977, p < 0.001). Especially at a cut‐off value of 44.14 ng/ml, uNGAL had a predictive value for CA‐AKI in elderly patients (AUC = 0.979, p < 0.001). Conclusions The rate of CA‐AKI after PCI in elderly patients was 23.5%. Urine NGAL before PCI had a good predictive value for CA‐AKI in elderly patients with chronic coronary artery disease.

Evaluation of Lac and NGAL on the Condition and Prognosis of Patients with Diquat Poisoning

“…Recent studies have shown that NGAL is an independent risk factor for AKI in elderly patients and can be used to evaluate the prognosis of DQ. 14,15 In this study, the blood NGAL levels of patients with AKI caused by DQ poisoning were significantly higher than those of healthy subjects on admission and increased with the aggravation of AKI, and the correlation analysis suggested that there was a positive correlation between the serum NGAL level and AKI grade. Furthermore, NGAL levels in the nonsurvival group were significantly higher than those in the survival group, suggesting that NGAL can determine the degree of organ function damage in patients and thus guide clinical treatment.…”