Serum NGAL and FGF23 may have certain value in early diagnosis of CIN

Ren Fail. 2018 Nov;40(1):547-553. doi: 10.1080/0886022X.2018.1487860.

Abstract

Aims: This study aimed to assess whether neutrophil gelatinase-associated lipocalin (NGAL) and fibroblast growth factor 23 (FGF23) could be reliable biomarkers for early diagnosis of contrast-induced nephropathy (CIN).

Methods: 202 patients who underwent percutaneous coronary intervention (PCI) were included in the research. All subjects were divided into CIN group and non-CIN group. Serum NGAL and FGF23 were evaluated before and 0, 1, and 2 days after PCI. Serum levels of these two markers were compared intra-group and among groups. Receiver-operating characteristic (ROC) analysis and logistic regression models were conducted to assess the diagnostic performance of NGAL and FGF23 in detecting CIN.

Results: When compared with baseline values, serum levels of both NGAL and FGF23 in all subjects increased after PCI, and the values peaked 1 day after PCI, but the changing was greater in CIN group. There were obvious differences between two groups in serum NGAL after 1, 2 days, and similar differences present in serum FGF23 after 1 day. ROC analysis showed that the area under the curve (AUC) of relative values (percent change from the baseline) in NGAL after 1 day was 0.899 (95% CI: 0.834-0.964, p = .000), the optimum cutoff was 49% (sensitivity = 80%, specificity = 92.4%). And the AUC in FGF23 was 0.814 (95% CI: 0.733-0.894, p = .000), the optimum cutoff was 20% (sensitivity = 73.3%, specificity = 87.6%). Both serum NGAL and serum FGF23 could improve the clinical models in identifying CIN.

Conclusions: NGAL and FGF23 may have certain value in early diagnosis of CIN.

Keywords: Neutrophil gelatinase-associated lipocalin; contrast-induced nephropathy; fibroblast growth factor 23; percutaneous coronary intervention.

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / diagnosis*
  • Aged
  • Biomarkers / blood
  • China
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects
  • Early Diagnosis*
  • Female
  • Fibroblast Growth Factor 2 / blood*
  • Fibroblast Growth Factor-23
  • Humans
  • Lipocalin-2 / blood*
  • Logistic Models
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects
  • ROC Curve
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • Contrast Media
  • FGF23 protein, human
  • Lipocalin-2
  • Fibroblast Growth Factor 2
  • Fibroblast Growth Factor-23

Grants and funding

This study was funded by National Natural Science Foundation of China [81173401].