Urinary neutrophil gelatinase-associated lipocalin predicted to contrast-associated acute kidney injury after planned percutaneous coronary intervention in elderly patients

J Clin Lab Anal. 2022 Dec;36(12):e24757. doi: 10.1002/jcla.24757. Epub 2022 Nov 10.

Abstract

Aim: To determine the proportion of contrast-associated acute kidney injury (CA-AKI) after percutaneous coronary intervention (PCI) and the predictive value of urine neutrophil gelatinase-associated lipocalin (uNGAL) for CA-AKI in elderly patients with chronic coronary artery disease.

Methods: A total of 509 patients who had planned percutaneous coronary intervention (mean age was 63.58 ± 11.63 years and 63.3% of males) were divided into two groups: group 1 (n = 153; elderly patients) with ≥70 years old and group 2 (n = 356) with <70 years old. Urine NGAL was measured by the ELISA method. Clinical and laboratory data were collected on the day before intervention. CA-AKI was defined based on Kidney Disease: Improving Global Outcomes criteria.

Results: The ratio of CA-AKI in group 1 was 23.5% which was higher than that of group 2 (8.7%) with a p-value < 0.001. Urine NGAL level in group 1 was significantly higher than that of group 2 [31.3 (19.16-55.13) ng/ml vs. 19.86 (13.21-29.04) ng/ml, p < 0.001]. At a cut-off value of 44.43 ng/ml, uNGAL had a predictive value for CA-AKI in all patients (AUC = 0.977, p < 0.001). Especially at a cut-off value of 44.14 ng/ml, uNGAL had a predictive value for CA-AKI in elderly patients (AUC = 0.979, p < 0.001).

Conclusions: The rate of CA-AKI after PCI in elderly patients was 23.5%. Urine NGAL before PCI had a good predictive value for CA-AKI in elderly patients with chronic coronary artery disease.

Keywords: Chronic coronary artery disease; contrast-associated acute kidney injury; elderly patients; urine neutrophil gelatinase-associated lipocalin.

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / epidemiology
  • Acute-Phase Proteins / urine
  • Aged
  • Biomarkers / urine
  • Coronary Artery Disease* / surgery
  • Female
  • Humans
  • Lipocalin-2
  • Lipocalins / urine
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention* / adverse effects
  • Proto-Oncogene Proteins

Substances

  • Acute-Phase Proteins
  • Biomarkers
  • Lipocalin-2
  • Lipocalins
  • Proto-Oncogene Proteins