Urinary and serum biomarkers after cardiac catheterization in diabetic patients with stable angina and without severe chronic kidney disease.
OBJECTIVE
Different serum and urinary biomarkers have been recently proposed to serve as markers of acute kidney injury. We tested the hypothesis whether NGAL and other biomarkers could represent an early biomarker of contrast nephropathy (CIN) in diabetic patients with normal serum creatinine undergoing cardiac catheterization in comparison with non-diabetic patients.


METHODS
Serum, urinary NGAL, cystatin C, urinary kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and liver-type fatty acid binding protein (L-FABP) were evaluated before and 2, 4, 8, 24, and 48 hours after cardiac catheterization using commercially available kits.


RESULTS
In both groups we found a significant rise in serum NGAL after 2, 4, and 8 hours, and in urinary NGAL and IL-18 after 4, 8, and 24 hours after cardiac catheterization. Serum cystatin C increased significantly 8 hours, reaching peak 24 hours after cardiac catheterization in both groups, and then decreased after 48 hours. L-FABP and KIM-1 increase significantly after 24 and 48 hours after cardiac catheterization.


CONCLUSIONS
CIN was similarly prevalent in both diabetic and non-diabetic patients undergoing cardiac catheterization. NGAL seems to be a potential early marker for nephrotoxicity and predictor of contrast nephropathy. It is particularly important in the upcoming setting of short-time hospitalizations for cardiac catheterization.
Malyszko
Jolanta
J
Department of Nephrology and Transplantology, Medical University, Bialystok, Poland. jolmal@poczta.onet.pl
Bachorzewska-Gajewska
Hanna
H
Poniatowski
Boguslaw
B
Malyszko
Jacek S
JS
Dobrzycki
Slawomir
S
D000209:Acute-Phase Proteins / Q000652:urine; D000368:Aged; D000787:Angina Pectoris / Q000150:complications*; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood / Q000652:urine; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood / Q000652:urine; D055316:Cystatin C / Q000097:blood; D003928:Diabetic Nephropathies / Q000139:chemically induced* / Q000378:metabolism; D005919:Glomerular Filtration Rate; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000652:urine; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000652:urine; D012044:Regression Analysis
D000209:Acute-Phase Proteins; D015415:Biomarkers; D003287:Contrast Media; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine