The clinical significance of neutrophil gelatinase-associated lipocalin in early kidney injury after elective percutaneous coronary intervention

Abstract

Objective To explore the clinical application value of neutrophil gelatinase-associated lipocalin（NGAL）which were tested by immunity transmission turbidity in early kidney injury after elective percutaneous coronary intervention. Methods A case-control study was conducted. All 201 stable angina pectoris and acute coronary syndrome patients undergone percutaneous coronary intervention in TEDA International Cardiovascular Hospital, during April to August 2013, were enrolled in this study. Before and 2 h,4 h,8 h,24 h,48 h after the operation, the plasma creatinine of the patient samples were tested by enzymic method. Before and 2 h, 4 h, 8 h, 24 h after the operation, the plasma NGAL was tested by immunity transmission turbidity method. Before and 8 h, 24 h after the operation, the urinary NGAL was tested by immunoturdimetric method. The data were compared between contrast induced nephrpathy (CIN) and non-CIN groups. For normal distribution of quantitative data, t test were used and for non-normal distribution of quantitative data, nonparametric rank and inspection were used. Results CIN occurred in 8 of 201 enrolled patients, the incidence was 3.98%. Receiver operating characteristic curve (ROC) analysis confirmed the diagnostic accuracy of the plasma NGAL in CIN, and the area under the curve（AUC） of 2 h plasma NGAL was 0.928，95%CI 0.800-0.985，with the cut-off value NGAL as 109 ng/ml, the diagnostic sensitivity and specificity for CIN were 87.5% and 100%；the AUC of 8 h plasma NGAL was 0.945，95%CI 0.824-0.992，with the cut-off value NGAL as 96 ng/ml, the diagnostic sensitivity and specificity for CIN were 87.5% and 87.5%；the AUC of 8 h urinary NGAL was 0.969, 95%CI 0.859-0.999 , with the cut-off value NGAL as 91 ng/ml, the diagnostic sensitivity and specificity for CIN were 87.5% and 100%. Conclusions The change of plasma and urinary NGAL is earlier to that of serum creatinine for the early diagnosis of CIN. It can be used as the predictor of early renal damage after elective coronary artery interventional. （Chin J Lab Med,2014,37: 517-521） Key words: Acute-phase proteins; Percutaneous coronary intervention; Kidney diseases