Relation of baseline neutrophil gelatinase-associated lipocalin (Ngal) levels and contrast-induced nephropathy following percutaneous coronary intervention among chronic kidney disease patients

Lior Lupu, Hytham Abukatash, Ariel Banai, Keren Lee Rozenfeld, Dana Lewit, Ilan Merdler, Itamar Loewenstein, Gil Bornstein, Shmuel Banai, Yacov Shacham

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: The risk of contrast-induced acute kidney injury (CI-AKI) following coronary intervention is particularly high among patients with chronic kidney disease (CKD). Among these patients, baseline neutrophil gelatinase-associated lipocalin (NGAL), a marker of tubular damage, reflects the severity of renal impairment. We evaluated whether the baseline serum NGAL level may be a marker for the development of CI-AKI following percutaneous coronary intervention (PCI). Methods: Eighty-eight CKD patients treated with PCI were included. Serum NGAL levels were drawn upon hospital admission. Receiver operator characteristic (ROC) methods were used to identify the optimal sensitivity and specificity for the observed NGAL level compared with the estimated glomerular filtration rate (eGFR) calculated for patients with CI-AKI. Results: Overall CI-AKI incidence was 43%. Baseline serum NGAL levels were significantly higher in patients with CI-AKI than in patients without CI-AKI (150 vs. 103 ng/mL, p < 0.001). According to the ROC curve, baseline NGAL levels performed better than eGFR to predict CI-AKI (AUC 0.753 vs. 0.604), with the optimal cutoff value for baseline NGAL to predict CI-AKI being 127 ng/mL (sensitivity of 68% and specificity of 68%, p < 0.001). In a multivariate logistic regression model, the NGAL level >127 ng/mL ng/mL was independently associated with CI-AKI (HR 9.84, 95% CI: 1.96–40.3; p = 0.01). Conclusion: Baseline serum NGAL levels in CKD patients may identify a high-risk population for CI-AKI following PCI. Further studies on larger populations are required to validate the potential utility of NGAL measurements in monitoring specific CKD-associated conditions.

Original languageEnglish
Article number5403
JournalJournal of Clinical Medicine
Volume10
Issue number22
DOIs
StatePublished - 19 Nov 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Acute kidney injury (AKI)
  • Chronic kidney disease (CKD)
  • Neutrophil gelatinase-associated lipocalin (NGAL)
  • ST-elevation myocardial infarction (STEMI)

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