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Kidney Week

Abstract: TH-PO097

Biomarkers in the Prediction of Contrast Media Induced Nephropathy: The BITCOIN Study

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Seibert, Felix S., University Hospital Marien Hospital Herne, Herne, Germany
  • Pagonas, Nikolaos, University Hospital Marien Hospital Herne, Herne, Germany
  • Westhoff, Timm H., University Hospital Marien Hospital Herne, Herne, Germany
Background

Subjects with chronic kidney disease (CKD) are at increased risk for the development of contrast-induced acute kidney injury (CI-AKI). It remains elusive, whether urinary biomarkers are able to identify subjects at increased risk as well. The present prospective trial examines the predictive value of urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), calprotectin, and Dickkopf-3 (DKK3) for the development of CI-AKI.

Methods

We enrolled 489 patients undergoing coronary angiography, 137 subjects had a CKD. An increase of serum creatinine concentration ≥ 0.3 mg/dl from baseline to day 2-3 was defined as CI-AKI and primary endpoint. Urinary calprotectin, NGAL, KIM-1 and DKK3 concentrations were assessed < 24h before coronary angiography.

Results

30 (6.1%) patients suffered from CI-AKI (27 AKIN stage I, 3 AKIN stage II, none AKIN stage III). Those subjects with CI-AKI showed significantly higher concentrations of NGAL (p=0.001) and DKK3 (p=0.001) at baseline. No difference was obtained for KIM-1 (p=0.057) and calprotectin (p=0.36). Predictive accuracy was assessed by receiver operating characteristics (ROC) calculations yielding an area under the curve (AUC) of 0.69 each. CI-AKI was twice as prevalent in 137 patients with CKD (n=15, 11%; no AKIN III, 2 CIN AKIN II). The AUC of eGFR to predict CI-AKI in the overall study population was 0.59.

Conclusion

The present study is the largest prospective study so far, investigating the use of urinary biomarkers for the risk assessment before application of contrast-media. Urinary NGAL and DDK3 are able to identify patients at risk for CI-AKI, whereas KIM-I and calprotectin do not.