title: Impact of serum alkaline phosphatase level on the pathophysiologic mechanism of contrast-induced nephropathy.
abstract: BACKGROUND
  Contrast-induced nephropathy (CIN) accounts for 10% of all causes of hospital-acquired renal failure. It leadsto a prolonged in-hospital stay, and represents a powerful predictor of poor early and late outcomes. More than half of casesare observed after cardiovascular procedures.
  
  
  OBJECTIVE
  To determine the predictive value of the serum alkaline phosphatase (ALP) level in the development of CIN, something which has not been assessed before.
  
  
  METHODS
  We prospectively evaluated a total of 430 patients with acute coronary syndrome. Patients were classified according to the development of CIN and both groups were compared statistically according to clinical, laboratory and demographic features, including the serum ALP level.
  
  
  RESULTS
  CIN was observed in 20.5% of patients. Advanced age, male gender, elevated creatinine, uric acid and phosphate levels, and low glomerular filtration rate were correlated with the development of CIN. Correlation analysis also showed a significant association between the ALP level and the development of CIN (126.1 ± 144.9 vs. 97.2 ± 46.9, p = 0.004). Univariate regression analysis also showed the impact of ALP on the development of CIN (OR 1.004, 95% CI 1.001–1.007, p = 0.02). Conclusions: Our outcomes indicate a possible active role of ALP in the mechanism of CIN. An elevated ALP level may predict the development of CIN.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karabulut
authors.forename: Irfan
authors.initials: I
authors.lastname: Sahin
authors.forename: Ilhan
authors.initials: I
authors.lastname: Ilker Avci
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Okuyan
authors.forename: Zeki
authors.initials: Z
authors.lastname: Dogan
authors.forename: Bulent
authors.initials: B
authors.lastname: Uzunlar
authors.forename: Mahmut
authors.initials: M
authors.lastname: Cakmak
authors.forename: Muhammet
authors.initials: M
authors.lastname: Gurdogan
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D058186:Acute Kidney Injury / Q000097:blood* / Q000139:chemically induced; D000469:Alkaline Phosphatase / Q000097:blood*; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D000469:Alkaline Phosphatase