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Persistent serum creatinine increase following contrast‐induced acute kidney injury
Author(s) -
Briguori Carlo,
Quintavalle Cristina,
De Micco Francesca,
Visconti Gabriella,
Di Palma Vito,
Napolitano Giovanni,
Focaccio Amelia,
Condorelli Gerolama
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27239
Subject(s) - medicine , creatinine , acute kidney injury , receiver operating characteristic , area under the curve , gastroenterology , renal function , urology , cardiology
Background Contrast‐induced acute kidney injury (CI‐AKI) may led to both a transient and a persistent serum creatinine (sCr) increase. Objectives To assess whether serum cystatin C (sCyC) and urine and serum neutrophil gelatinase‐associated lipocalin (uNGAL, sNGAL) are useful in the early identification of persistent sCr increase following CI‐AKI. Methods One hundred and eighteen patients who developed CI‐AKI were included into the study. Persistent sCr elevation was defined as a persistent increase ≥0.3 mg dL −1 at 1 month after contrast media (CM) administration. Results sCr levels recovered in 87 patients (74%; Transient group), whereas a persistent elevation of sCr was observed in the remaining 31 patients (26%; Persistent group). By multivariable logistic regression analysis, independent predictors of persistent sCr increase were insulin therapy, uNGAL at 48 hr and absolute sCr difference between 48 and 72 hr. On the contrary, sCyC assessment did not help in the early identification of this subset of patients. By receiver operating curve analysis, the best cutoff values for predicting persistent sCr increase were uNGAL ≥0.50 ng dL −1 at 48 hr, and the absolute sCr increase ≥0.20 mg dL −1 between 48 and 72 hr. Conclusions uNGAL ≥0.50 ng dL −1 at 48 hr and absolute sCr increase ≥0.20 mg dL −1 between 48 and 72 hr but not sCyC are useful in the early identification of patients developing persistent sCr increase after CM administration.