Changes in urinary and serum markers of renal injury in adult patients after angiographic contrast medium administration
Abstract
Objective: Monitoring of renal injury parameters changes after contrast medium (CM) administration in patients after angiographic examination, depending on the initial estimated glomerular filtration (eGF). Design: Prospective study.
Settings: Department of Medical Chemistry and Clinical Biochemistry, University Hospital Motol, Charles University, Second Faculty of Medicine; Department of Cardiology, University Hospital Motol, Charles University, Second Faculty of Medicine; V Úvalu 84, 150 06 Prague 5 (Czech Republic). Material and Methods: The study included 40 patients who underwent angiographic examination.
Based on the input value of eGFCKD-EPI, we divided the entire group into two subgroups: subgroup with eGF >= 1 mL/s/1.73 m2 was composed of 28 patients (19 M and 9 F, age 61.5 +- 10.7 years) and a subgroup with eGF < 1 mL/s/1.73 m2 of 12 patients (5 M and 7 F, age 74.6 +- 6.2 years). At 0, 4 and 24 hours after the CM administration, serum samples were taken to examine creatinine and cystatin C, and, at 0, 4, 12, and 24 hours following the CM administration urine samples were taken to examine neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), α-1-microglobulin, albumin and creatinine.
The bootstrap statistical methods were used for statistical analyses. Results: At 12 and 24 hours after CM administration, there were a statistically significant increase in urinary concentrations of NGAL, α-1-microglobulin (p < 0.05) and NAG (p = 0.05 in time 24 hours); no statistically significant changes in albuminuria, serum creatinine and cystatin C concentrations, or GF derived from these markers occurred within 24 hours after CM administration.
All monitored markers developed similarly in each subgroup. Conclusion: In our study, in patients after CM administration, the increase of urinary NGAL, α-1-microglobulin and NAG concentrations was preceded by an increase in serum creatinine, cystatin C and albuminuria.