title: Urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) and contrast-induced acute kidney injury after coronary angiogram.
abstract: OBJECTIVE
  Diagnosis of acute kidney injury (AKI) relies on measurement of serum creatinine (SCr). SCr is a late marker of impaired renal function. Urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) has given encouraging results for an early and sensitive detection of AKI. This cohort study was conducted (1) to assess the value of uNGAL as early marker of contrast-induced AKI (CI-AKI) in unselected patients undergoing percutaneous coronary procedure (PCP) and (2) to investigate whether uNGAL levels correlate with the volume of contrast medium (CM) used during the procedure.
  
  
  METHODS
  We enrolled 244 consecutive adult patients undergoing PCP done with the low-osmolar CM Iomeprolum (median volume of CM 122 [88-168] ml per procedure). uNGAL was measured at its peak with a standardised clinical laboratory platform (ARCHITECT uNGAL assay, Abbott).
  
  
  RESULTS
  Overall, the post-PCP uNGAL levels were extremely low in our cohort with a median value of 7.7 [4.0-14.5] ng/ml (N ≤132 ng/ml). Twenty-five (10%) patients developed CI-AKI according to the classical diagnostic criteria (≥25% or ≥44.2 µmol/l increase in SCr) and 8 (3.3%) patients according to the AKIN criteria. Regardless of the definition considered, uNGAL levels did not significantly differ in patients with or without CI-AKI. Similarly, we found no significant correlation between the volume of CM used and the post-PCP uNGAL levels (r = -0.11).
  
  
  CONCLUSIONS
  In a large cohort of unselected adult patients, uNGAL measured four to six hours after PCP was ineffective to predict the risk of CI-AKI and did not correlate with the volume of CM used during the procedure.
authors.affiliation: Department of Cardiology, University & Hospital Fribourg, Switzerland; tilman.perrin@bluewin.ch.
authors.forename: Tilman
authors.initials: T
authors.lastname: Perrin
authors.forename: Eric
authors.initials: E
authors.lastname: Descombes
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Magnin
authors.forename: Magali
authors.initials: M
authors.lastname: Gachet
authors.forename: Ould Maouloud
authors.initials: OM
authors.lastname: Hemett
authors.forename: Daniel
authors.initials: D
authors.lastname: Hayoz
authors.forename: Valérie
authors.initials: V
authors.lastname: Stolt
authors.forename: Gérard
authors.initials: G
authors.lastname: Baeriswyl
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Stauffer
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Goy
authors.forename: Mario
authors.initials: M
authors.lastname: Togni
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cook
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D015415:Biomarkers / Q000652:urine; D015331:Cohort Studies; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000009:adverse effects / Q000031:analogs & derivatives*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D003287:Contrast Media; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; C057937:iomeprol; D003404:Creatinine; D007479:Iopamidol