title: Relative and absolute changes in urinary neutrophil gelatinase-associated lipocalin and correlation with small increases in serum creatinine levels after coronary angiography: an observational study.
abstract: OBJECTIVE
  The Acute Kidney Injury Network classification is based on small increases in serum creatinine (sCr) for stage 1. This study investigated whether changes in the urinary concentration of neutrophil gelatinase-associated lipocalin (uNGAL) could predict small increases in sCr in patients undergoing coronary angiography.
  
  
  METHODS
  The uNGAL was measured before contrast infusion and 2 and 4 h afterwards. Patients were divided into 2 subgroups: G1 (n = 103), where sCr increased by <0.3 mg/dl, and G2 (n = 22), where sCr increased by ≥0.3 mg/dl 48 h after the angiography. To determine the sensitivity and specificity for the absolute and relative variations of uNGAL, a receiver operating characteristic curve analysis was performed.
  
  
  RESULTS
  In G2, the uNGAL concentration increased over baseline values (15.9 vs. 9.2 ng/dl; p < 0.05), and it was also 2-fold higher in G2 versus G1 (15.9 vs. 8.0 ng/dl; p < 0.001). The uNGAL remains an independent predictor of the small increases in sCr, and, for an increase of 50% over baseline levels, it showed 60% sensitivity and 81% specificity.
  
  
  CONCLUSIONS
  Changes in uNGAL concentration 2 h after the infusion of contrast media showed marginal sensitivity to predict small increases in sCr.
authors: Department of Internal Medicine, Federal University of Uberlândia, Uberlândia, Brazil.
authors: Denis F
authors: DF
authors: Souza
authors: Samir S A
authors: SS
authors: Reis
authors: Roberto V
authors: RV
authors: Botelho
authors: Sebastião R
authors: SR
authors: Ferreira-Filho
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D000209:Acute-Phase Proteins; D003287:Contrast Media; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine