The role of neutrophil-gelatinase-associated lipocalin in early diagnosis of contrast nephropathy

MR Khatami; M. R. P Sabbagh; N Nikravan; Z Khazaeipour; MA Boroumand; S Sadeghian; B Davoudi

doi:10.4103/0971-4065.147370

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ORIGINAL ARTICLE

Year : 2015 | Volume : 25 | Issue : 5 | Page : 292-296

The role of neutrophil-gelatinase-associated lipocalin in early diagnosis of contrast nephropathy

MR Khatami¹, M. R. P Sabbagh², N Nikravan¹, Z Khazaeipour³, MA Boroumand⁴, S Sadeghian⁴, B Davoudi⁴
¹ Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
² Imam Khomeini Hospital, Tehran University of Medical Sciences, Internal Medicine Ward, Imam Khomeini Hospital, Keshavarz Blvd, Tehran, Iran
³ Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
⁴ Tehran Heart Center, Tehran University of Medical Sciences, North Karegar Ave., Tehran, Iran

Correspondence Address:
M R Khatami
Nephrology Research Center, Imam Khomeini Hospital, Keshavarz Blvd, 1419733141, Tehran
Iran

Source of Support: A grant by research deputy of Tehran University of Medical Sciences,, Conflict of Interest: None

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DOI: 10.4103/0971-4065.147370

Neutrophil-gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury. The aim of this study was to define a cut-off for NGAL in the early diagnosis of contrast-induced nephropathy (CIN) in patients with normal kidney function. We enrolled 121 patients with normal serum creatinine who underwent coronary angiography. NGAL was measured in urine before the procedure and 12 and 24 h afterward. CIN was defined as a 0.3 mg/dl increase in serum creatinine within 48 h after the procedure. Seven of 121 patients had CIN (5.8%). The NGAL levels in the 12- and 24-h urine samples of these patients were 30 (5-45) and 20 (15-40) ng/ml, respectively, whereas those in patients without CIN were 15 (5-45) and 15 (10-51) ng/ml, respectively (P = 0.8). In patients with CIN, the sensitivity and specificity of NGAL with a cut-off of 22.5 ng/ml were 71.4% and 57.9% in 12-h urine samples, with the negative predictive values (NPV) and positive predictive values (PPV) of 97.1% and 9.4%, respectively. In conclusion, we suggest that urine NGAL with cut-off point of 22.5 ng/ml has acceptable sensitivity and specificity for early diagnosis of CIN in patients with normal serum creatinine, but regarding NPV and PPV the best performance of this value is to rule out the CIN in patients at risk who received contrast media.

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