Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients

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 seve...

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Autores principales:	Lior Lupu, Hytham Abukatash, Ariel Banai, Keren-Lee Rozenfeld, Dana Lewit, Ilan Merdler, Itamar Loewenstein, Gil Bornstein, Shmuel Banai, Yacov Shacham
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	neutrophil gelatinase-associated lipocalin (NGAL) acute kidney injury (AKI) chronic kidney disease (CKD) ST-elevation myocardial infarction (STEMI) Medicine R
Acceso en línea:	https://doaj.org/article/332d8b237c43483990b3838be63b95fc
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spelling	oai:doaj.org-article:332d8b237c43483990b3838be63b95fc2021-11-25T18:02:28ZRelation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients10.3390/jcm102254032077-0383https://doaj.org/article/332d8b237c43483990b3838be63b95fc2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5403https://doaj.org/toc/2077-0383Background: 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, <i>p</i> < 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%, <i>p</i> < 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; <i>p</i> = 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.Lior LupuHytham AbukatashAriel BanaiKeren-Lee RozenfeldDana LewitIlan MerdlerItamar LoewensteinGil BornsteinShmuel BanaiYacov ShachamMDPI AGarticleneutrophil gelatinase-associated lipocalin (NGAL)acute kidney injury (AKI)chronic kidney disease (CKD)ST-elevation myocardial infarction (STEMI)MedicineRENJournal of Clinical Medicine, Vol 10, Iss 5403, p 5403 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	neutrophil gelatinase-associated lipocalin (NGAL) acute kidney injury (AKI) chronic kidney disease (CKD) ST-elevation myocardial infarction (STEMI) Medicine R
spellingShingle	neutrophil gelatinase-associated lipocalin (NGAL) acute kidney injury (AKI) chronic kidney disease (CKD) ST-elevation myocardial infarction (STEMI) Medicine R Lior Lupu Hytham Abukatash Ariel Banai Keren-Lee Rozenfeld Dana Lewit Ilan Merdler Itamar Loewenstein Gil Bornstein Shmuel Banai Yacov Shacham Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients
description	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, <i>p</i> < 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%, <i>p</i> < 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; <i>p</i> = 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.
format	article
author	Lior Lupu Hytham Abukatash Ariel Banai Keren-Lee Rozenfeld Dana Lewit Ilan Merdler Itamar Loewenstein Gil Bornstein Shmuel Banai Yacov Shacham
author_facet	Lior Lupu Hytham Abukatash Ariel Banai Keren-Lee Rozenfeld Dana Lewit Ilan Merdler Itamar Loewenstein Gil Bornstein Shmuel Banai Yacov Shacham
author_sort	Lior Lupu
title	Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients
title_short	Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients
title_full	Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients
title_fullStr	Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients
title_full_unstemmed	Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients
title_sort	relation of baseline neutrophil gelatinase-associated lipocalin (ngal) levels and contrast-induced nephropathy following percutaneous coronary intervention among chronic kidney disease patients
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/332d8b237c43483990b3838be63b95fc
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Relation of Baseline Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Contrast-Induced Nephropathy following Percutaneous Coronary Intervention among Chronic Kidney Disease Patients

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