title: The role of neutrophil-gelatinase-associated lipocalin in early diagnosis of contrast nephropathy.
abstract: Neutrophil-gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury. The aim of this study was to define a cut-off for NGAL in the early diagnosis of contrast-induced nephropathy (CIN) in patients with normal kidney function. We enrolled 121 patients with normal serum creatinine who underwent coronary angiography. NGAL was measured in urine before the procedure and 12 and 24 h afterward. CIN was defined as a 0.3 mg/dl increase in serum creatinine within 48 h after the procedure. Seven of 121 patients had CIN (5.8%). The NGAL levels in the 12- and 24-h urine samples of these patients were 30 (5-45) and 20 (15-40) ng/ml, respectively, whereas those in patients without CIN were 15 (5-45) and 15 (10-51) ng/ml, respectively (P = 0.8). In patients with CIN, the sensitivity and specificity of NGAL with a cut-off of 22.5 ng/ml were 71.4% and 57.9% in 12-h urine samples, with the negative predictive values (NPV) and positive predictive values (PPV) of 97.1% and 9.4%, respectively. In conclusion, we suggest that urine NGAL with cut-off point of 22.5 ng/ml has acceptable sensitivity and specificity for early diagnosis of CIN in patients with normal serum creatinine, but regarding NPV and PPV the best performance of this value is to rule out the CIN in patients at risk who received contrast media.
authors.affiliation: Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: M R
authors.initials: MR
authors.lastname: Khatami
authors.affiliation: Imam Khomeini Hospital, Tehran University of Medical Sciences, Internal Medicine Ward, Imam Khomeini Hospital, Keshavarz Blvd, Tehran, Iran.
authors.forename: M R P
authors.initials: MR
authors.lastname: Sabbagh
authors.affiliation: Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Nikravan
authors.affiliation: Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Z
authors.initials: Z
authors.lastname: Khazaeipour
authors.affiliation: Tehran Heart Center, Tehran University of Medical Sciences, North Karegar Ave., Tehran, Iran.
authors.forename: M A
authors.initials: MA
authors.lastname: Boroumand
authors.affiliation: Tehran Heart Center, Tehran University of Medical Sciences, North Karegar Ave., Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Sadeghian
authors.affiliation: Tehran Heart Center, Tehran University of Medical Sciences, North Karegar Ave., Tehran, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Davoudi
keywords: Acute kidney injury; contrast nephropathy; coronary angiography; neutrophil-gelatinase-associated lipocalin; serum creatinine