title: No increase in Kidney Injury Molecule-1 and Neutrophil Gelatinase-Associated Lipocalin excretion following intravenous contrast enhanced-CT.
abstract: OBJECTIVE
  To analyze kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (N-GAL) excretion post-intravenous contrast enhanced-CT (CE-CT) in patients with chronic kidney disease (CKD).
  
  
  METHODS
  Patients were enrolled in a trial on hydration regimes to prevent contrast-induced acute kidney injury (CI-AKI). Blood and urine samples were taken at baseline, 4 - 6, and 48 - 96 h post CE-CT. Urinary KIM-1 and N-GAL values were normalized for urinary creatinine levels, presented as medians with 2.5 - 97.5 percentiles.
  
  
  RESULTS
  Of the enrolled 511 patients, 10 (2%) were lost to follow-up. CI-AKI occurred in 3.9% of patients (20/501). Median KIM-1 values were 1.2 (0.1 - 7.7) at baseline, 1.3 (0.1 - 8.6) at 4 - 6 h, and 1.3 ng/mg (0.1 - 8.1) at 48 - 96 h post CE-CT (P = 0.39). Median N-GAL values were 41.0 (4.4 - 3,174.4), 48.9 (5.7 - 3,406.1), and 37.8 μg/mg (3.5 - 3,200.4), respectively (P = 0.07). The amount of KIM-1 and N-GAL excretion in follow-up was similar for patients with and without CI-AKI (P-value KIM-1 0.08, P-value N-GAL 0.73). Neither patient characteristics at baseline including severe CKD, medication use, nor contrast dose were associated with increased excretion of KIM-1 or N-GAL during follow-up.
  
  
  CONCLUSIONS
  KIM-1 and N-GAL excretion were unaffected by CE-CT both in patients with and without CI-AKI, suggesting that CI-AKI was not accompanied by tubular injury.
  
  
  CONCLUSIONS
  • KIM-1 and N-GAL excretion were unaffected by intravenous contrast-enhanced CT (CE-CT). • Patient or procedure characteristics were not associated with increased KIM-1 or N-GAL excretion. • Performance of CE-CT in CKD patients is likely to be safe.
authors.affiliation: Department of Thrombosis and Haemostasis, Leiden University Medical Center, Albinusdreef 2, Postzone C7-Q, 2333 ZA, Leiden, The Netherlands, j.kooiman@lumc.nl.
authors.forename: Judith
authors.initials: J
authors.lastname: Kooiman
authors.forename: Wilke R
authors.initials: WR
authors.lastname: van de Peppel
authors.forename: Yvo W J
authors.initials: YW
authors.lastname: Sijpkens
authors.forename: Harald F H
authors.initials: HF
authors.lastname: Brulez
authors.forename: P M
authors.initials: PM
authors.lastname: de Vries
authors.forename: Mioara A
authors.initials: MA
authors.lastname: Nicolaie
authors.forename: H
authors.initials: H
authors.lastname: Putter
authors.forename: Menno V
authors.initials: MV
authors.lastname: Huisman
authors.forename: W
authors.initials: W
authors.lastname: van der Kooij
authors.forename: Cees
authors.initials: C
authors.lastname: van Kooten
authors.forename: Ton J
authors.initials: TJ
authors.lastname: Rabelink
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000652:urine; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D017613:Iodine Compounds / Q000009:adverse effects*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood / Q000652:urine*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood / Q000652:urine*; D011518:Proto-Oncogene Proteins / Q000097:blood / Q000652:urine*; D011991:Receptors, Virus / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000652:urine; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D003287:Contrast Media; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D017613:Iodine Compounds; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D003404:Creatinine