Elevation of urinary liver-type fatty acid-binding protein as predicting factor for occurrence of contrast-induced acute kidney injury and its reduction ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-04-20

AUTHORS

Hiromasa Katoh, Tsuyoshi Nozue, Yuya Kimura, Sei Nakata, Taku Iwaki, Mitsuhiro Kawano, Masa-aki Kawashiri, Ichiro Michishita, Masakazu Yamagishi

ABSTRACT

Although contrast-induced acute kidney injury (CI-AKI) has a great impact on patients’ prognosis, few data exist regarding predictors of CI-AKI in patients with severe renal dysfunction who have undergone contrast angiography. Therefore, we prospectively studied 25 patients with renal dysfunction, which was defined as the estimated glomerular filtration rate (eGFR) level <45 ml/min/1.73 m2, undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). We performed hemodiafiltration with blood suction from the right atrium (RA-HDF). The mean level of urinary liver-type fatty acid-binding protein (L-FABP) at baseline was significantly higher in the CI-AKI group than in the non-CI-AKI group (59.8 ± 45.6 vs 13.4 ± 11.9 μg/gCr, P = 0.0003). Multivariate regression analysis demonstrated that baseline urinary L-FABP was an independent significant predictor of CI-AKI (β = 0.741, P = 0.013). Receiver-operating characteristic analysis showed that baseline urinary L-FABP exhibited 100 % sensitivity and 81.8 % specificity for predicting CI-AKI when the cutoff value was defined as 19.0 μg/gCr. Interestingly, the incidence of CI-AKI after CAG or PCI was reduced in the RA-HDF group in a comparison with 41 control patients (12 % vs 27 %) with eGFR level <45 ml/min/1.73 m2 who underwent PCI before the introduction of RA-HDF. In conclusion, baseline L-FABP levels can be a predictor for occurrence of CI-AKI. We suggest that RA-HDF may prevent the development of CI-AKI in patients with severe renal dysfunction undergoing coronary procedures, although further large-scale prospective study is necessary to confirm our conclusions. More... »

PAGES

191-197

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-013-0347-9

DOI

http://dx.doi.org/10.1007/s00380-013-0347-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032324886

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23604313


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36 schema:description Although contrast-induced acute kidney injury (CI-AKI) has a great impact on patients’ prognosis, few data exist regarding predictors of CI-AKI in patients with severe renal dysfunction who have undergone contrast angiography. Therefore, we prospectively studied 25 patients with renal dysfunction, which was defined as the estimated glomerular filtration rate (eGFR) level <45 ml/min/1.73 m2, undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). We performed hemodiafiltration with blood suction from the right atrium (RA-HDF). The mean level of urinary liver-type fatty acid-binding protein (L-FABP) at baseline was significantly higher in the CI-AKI group than in the non-CI-AKI group (59.8 ± 45.6 vs 13.4 ± 11.9 μg/gCr, P = 0.0003). Multivariate regression analysis demonstrated that baseline urinary L-FABP was an independent significant predictor of CI-AKI (β = 0.741, P = 0.013). Receiver-operating characteristic analysis showed that baseline urinary L-FABP exhibited 100 % sensitivity and 81.8 % specificity for predicting CI-AKI when the cutoff value was defined as 19.0 μg/gCr. Interestingly, the incidence of CI-AKI after CAG or PCI was reduced in the RA-HDF group in a comparison with 41 control patients (12 % vs 27 %) with eGFR level <45 ml/min/1.73 m2 who underwent PCI before the introduction of RA-HDF. In conclusion, baseline L-FABP levels can be a predictor for occurrence of CI-AKI. We suggest that RA-HDF may prevent the development of CI-AKI in patients with severe renal dysfunction undergoing coronary procedures, although further large-scale prospective study is necessary to confirm our conclusions.
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42 schema:keywords CI-AKI
43 CI-AKI group
44 EGFR levels
45 L-FABP levels
46 acid-binding protein
47 acute kidney injury
48 analysis
49 angiography
50 atrium
51 baseline
52 blood suction
53 characteristic analysis
54 comparison
55 conclusion
56 contrast angiography
57 contrast-induced acute kidney injury
58 control patients
59 coronary angiography
60 coronary intervention
61 coronary procedures
62 cutoff value
63 data
64 development
65 dysfunction
66 elevation
67 factors
68 fatty acid-binding protein
69 further large-scale prospective studies
70 glomerular filtration rate (eGFR) levels
71 great impact
72 group
73 hemodiafiltration
74 impact
75 incidence
76 independent significant predictors
77 injury
78 intervention
79 introduction
80 kidney injury
81 large-scale prospective studies
82 levels
83 liver-type fatty acid-binding protein
84 m2
85 mean levels
86 multivariate regression analysis
87 occurrence
88 patients
89 percutaneous coronary intervention
90 predictors
91 procedure
92 prognosis
93 prospective study
94 protein
95 rate levels
96 receiver-operating characteristic analysis
97 reduction
98 regression analysis
99 renal dysfunction
100 right atrium
101 sensitivity
102 severe renal dysfunction
103 significant predictors
104 specificity
105 study
106 suction
107 urinary L-FABP
108 urinary liver-type fatty acid-binding protein
109 values
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