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Biomarkers in the prediction of contrast media induced nephropathy – the BITCOIN study

PLoS Neglected Tropical Diseases Jul 20, 2020

Seibert FS, Heringhaus A, Pagonas N, et al. - Given a raised risk for contrast-induced acute kidney injury (CI-AKI) in patients with chronic kidney disease, researchers undertook this prospective analysis to investigate if tubular as well as inflammatory biomarkers enable the identification of people at increased risk. Overall 490 patients undergoing coronary angiography participated. The primary endpoint (CI-AKI) was a rise of serum creatinine level ≥ 0.3 mg/dl from baseline to day 2–3. A 3.1 fold higher baseline urinary NGAL (neutrophil gelatinase-associated lipocalin)/creatinine ratios were detected in patients who encountered CI-AKI vs those without CI-AKI. For NGAL/creatinine, an AUC of 0.68 was generated in ROC analyses. A negative predictive value of 96.5% was yielded by an NGAL/creatinine ratio < 56.4 μg/mg. This work represents the largest inquiry on the application of urinary biomarkers for CI-AKI risk stratification so far. Overall, findings showed the utility of NGAL in affording prognostic information beyond the glomerular biomarkers estimated glomerular filtration rate and proteinuria.

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