The Potential Role of Novel Kidney Biomarkers in Diagnosis of Early Contrast-Induced Nephropathy Following Coronary Angiography

Abstract

Background: Acute kidney injury (AKI) is a clinical syndrome that develops when a sudden kidney function impairment occurs. The reported rate of contrast-induced nephropathy (CIN) in cases following coronary angiography (CAG) ranges from 10 to 20%. The prevalence of CIN in subjects with regular kidney role is low (0–5%). Apart from determining serum creatinine (a delayed indicator of renal function but not its injury), recent biomarkers of AKI would be helpful in the diagnosis of CIN in the context of CAG. Cystatin C (Cys C), Neutrophil gelatinase-associated lipocalin (NGAL), Kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) have been suggested as potential markers for early AKI. 

Aim: This study evaluates the serum levels of the AKI indicators in cases undergoing CAG and assesses their role in the early detection of AKI associated with CIN.

Subjects & Methods: The study involved 31 cases that underwent coronary angiography (CAG) and obtained contrast agent (Ultravest), in addition to 15 sex and age-matched healthy individuals as control class. Serum concentrations of kidney biomarkers (KIM-1, NGAL, Cys C, andIL-18) were measured prior to and 6 hours post CAG using Luminex 100 ^TM readout System.

Results: The serum concentrationsof IL-18 and Cys C were greater in studied cases prior to CAG compared to controls (p <0.05). Casesthat underwent CAG showed a highly significant elevation in KIM -1 (p <0.001) level and a significant elevation in Cys C (p <0.05) level 6 h post CAG procedure. No significant differences were observed in serum levels of NGAL and IL-18 6 h post-CAG.

Conclusion: Serum Cys C and KIM-1 levels could reflect early affection of renal function in cases undergoing CAG. Thus assessment of serum Cys C and KIM-1would provide a solid base for the early detection of CIN.