The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

Angiology. 2019 May;70(5):458-464. doi: 10.1177/0003319718809200. Epub 2018 Oct 29.

Abstract

Contrast-induced nephropathy (CIN) is acute kidney failure that occurs after exposure to contrast agent. There is no sensitive biomarker to predict the development of CIN. In a retrospective study, we investigated the predictive value of the fibrinogen to albumin ratio (FAR) to determine the risk of CIN in patients (N = 246) who underwent carotid angiography. Contrast-induced nephropathy was defined as a 0.5 mg/dL or 25% increase in serum creatinine levels 48 to 72 hours following exposure to a radiocontrast agent. Patients were grouped according to whether they developed CIN or not, that is, CIN(-) and CIN(+) groups, respectively. Contrast-induced nephropathy developed in 39 (15.8%) of all the patients. The fibrinogen levels, neutrophil to lymphocyte ratio (NLR), and FAR in the CIN (+) group were higher than in the CIN (-) group ( P < .001). Multivariate analysis showed that age, diabetes, NLR, platelet-lymphocyte ratio, and FAR were independent risk factors for CIN. The area under the curve (AUC) of FAR was 0.800 for the prediction of CIN, and the best cutoff value was 57.4 with sensitivity, specificity, positive predictive value, and negative predictive value of 74.4%, 60.8%, 26.4%, and 92.7%, respectively. The FAR may be useful as a predictor of CIN.

Keywords: carotid angiography; contrast-induced nephropathy; fibrinogen to albumin ratio.

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angiography / adverse effects*
  • Biomarkers / blood
  • Carotid Arteries / diagnostic imaging*
  • Contrast Media / adverse effects*
  • Creatinine / blood
  • Female
  • Fibrinogen / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Serum Albumin, Human / metabolism*
  • Time Factors

Substances

  • Biomarkers
  • Contrast Media
  • Fibrinogen
  • Creatinine
  • Serum Albumin, Human