Plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Creatinine Levels after Percutaneous Coronary Intervention

Abstract

Background. Contrast-induced nephropathy (CIN) is defined as an increase in serum creatinine ≥ 25% or ≥0.3 mg/dl in 48 hours after the administration of a contrast agent in the absence of other causative factors (KDIGO 2012). Neutrophil Gelatinase-Associated Lipocalin (NGAL) is a substance produced by the kidneys in acute kidney injury (AKI) caused by various insults from ischemia to toxin-induced nephropathy. NGAL is known to increase earlier than serum creatinine level. NGAL is also a protease-resistant polypetide; it is released from the distal tubule, secreted to the urine or returned to the plasma (back leak), freely filtered in the glomerulus, reabsorbed in the proximal tubule through the megalin receptor endocytosis or secreted to urine. This makes NGAL detectable both in the blood and urine. Aim. To elucidate the effect of contrast administration to serum NGAL and serum creatinine levels with in patients undergoing PCI. Methods. The study was done in the Cardiovascular Care ward in M. Djamil General Hospital, Padang, West Sumatra, Indonesia. Through consecutive random sampling, 21 subjects were selected. The subjects’ serum NGAL and creatinine levels were acquired before PCI and 6 hours after contrast administration. Results. The mean serum NGAL and creatinine levels of the subjects before and after contrast administration were 52.26 ng/ml vs 64.78 ng/ml and 1.1 mg/dl vs 1.09 mg/dl, respectively. The serum NGAL level difference before and after contrast administration was statistically significant (p=0.003) whereas the serum creatinine level was not (p>0.005). Conclusion. There is an increase of serum NGAL levels before and after contrast administration in patient undergoing PCI, whereas serum creatinine level was not. Future studies should elaborate on the use of NGAL as an early diagnostic marker for CIN.