Abstract: SA-PO071

Role of Urinary NGAL at 4 Hours Post Coronary Angiogram in Detecting Contrast Induced AKI

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Author

  • Venkatesan, Madhav, Amrita Institute of Medical Sciences, Trichy, India
Background

Serum creatinine is an unreliable biomarker of acute kidney injury(AKI). Newer biomarkers can diagnose AKI earlier. We attempted to determine the sensitivity, specificity, positive and negative predictive values of urine NGAL in detecting CI-AKI post a coronary angiogram, and to study the risk factors of CI-AKI.

Methods

240 patients undergoing coronary angiogram were prospectively studied. Patients with a starting serum creatinine of more than 1.4mg/dl were excluded from the study. Serum creatinine and urine NGAL were measured before the procedure. Urine NGAL was measured 4 hours post procedure and serum creatinine was measured at 48 hours post procedure.

Results

The incidence of CI AKI in patients who underwent coronary angiogram was 8%. There was a rise in urinary NGAL in 95% of these patients (n=18). The sensitivity and specificity of urine NGAL at 4 hours were 94.7% and 99.1% respectively. The positive and negative predicitve values were 90% and 99.5% respectively. Age more than 75 years, presence of diabetes mellitus, congestive heart failure, prior history of CI-AKI and anemia had significant association with CI-AKI. Multivariate analysis showed that CHF and anemia were significantly associated with increased risk of CI-AKI.

Conclusion

Urine NGAL has a high sensitivity and specificity in the diagnosis of contrast induced acute kidney injury post coronary angiogram. Age above 75 years, diabetes mellitus, congestive heart failure , anemia and previous history of contrast induced AKI were significant risk factors for CI-AKI. Congestive heart failure and anemia were the risk factors with highest association with CI AKI. Based on our study we suggest that urine NGAL may be used for early detection of contrast induced acute kidney injury post a coronary angiogram with sensitivity and specificity of 94.7% and 99.1% respectively and with positive and negative predicitve values of 90%. and 99.5% respectively.

Association of rise in urine NGAL with CI-AKI