Comparison of Plasma Neutrophil Gelatinase Associated Lipocalin [NGAL] with Cystatin C and Serum Creatinine as an Early indicator of renal dysfunction following Coronary Angiography
Journal Title: International Journal of Medical and Health Sciences - Year 2013, Vol 2, Issue 2
Abstract
Background: Contrast induced acute kidney injury [CIAKI ] recently has been found to be the third common cause of acute kidney injury[AKI] .Interventional cardiology has advanced now with frequent coronary angiography and angioplasty necessitating administration of radiocontrast dye. Hence Contrast induced nephropathy [CIN] is on the increase in clinical practice and is an important complication to look for following angiography. Though serum creatinine is still the gold standard for diagnosing AKI, we need a reliable early biomarker to identify early renal dysfunction in these patients. Aim of the study: This is a prospective study to evaluate the role of plasma Neutrophil Gelatinase Associated Lipocalin [NGAL] in the early detection of contrast induced renal injury in patients undergoing coronary angiography and compare it with conventional markers. Materials and Methods:The present study included 40 patients who underwent coronary angiography. 25 patients were categorised as Group I who had preangiography plasma NGAL in normal range. 15 patients were categorised as Group II who had elevated preangiography plasma NGAL levels. Venous blood samples were collected from the patients before, after 4hours and after 24 hours following angiography. Blood levels of creatinine, urea, Cystatin C and NGAL were estimated. Results: Out of 40 patients taken for the study, 6 in Group I [24%] and 3 in Group II [20%] showed significant rise in 4th hour plasma NGAL following angiography compared to its preangiography values [p< 0.05]. However, Plasma Cystatin C, serum creatinine and urea did not show significant rise in both the groups at 4th hour period as well as after 24 hours [P>0.05]. Plasma NGAL which shows significant rise as early as 4 hours after angiography when compared to conventional markers could qualify as an early marker for detecting renal dysfunction before setting in of AKI. Conclusion: Plasma NGAL level may provide an early, simple and non invasive biomarker for predicting contrast induced nephropathy.
Authors and Affiliations
Vijayasamundeeswari, Jones Ronald, Visala sree. J
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