The effects of contrast agents on renal function

ABSTRACT Introduction and Aim: Acute kidney injury (AKI) is defined as loss of renal function depending on any cause over hours to days. One of the major causes of AKI is Contrast induced nephropathy (CIN). Greater than 25% increase of serum creatinine according to baseline creatinine or an absolute increse in serum creatinine of 0.5 g / dL after 48-72 hours from contrast agent uptake is defined as CIN. CIN is the third most common cause of hospital acquired AKI, after hypotension and surgery. New biomarkers was investigated for CIN due to level of serum creatinine is not to rise in the early stages of Nephrotoxicity and affects from other reasons. Neutrophil Gelatinase-Associated Lipocalin (NGAL), cystatin C and Kidney Injury Molecule (KIM-1) are recently new generation of early biomarkers. These molecules increase in serum and urine before an increase in serum creatinine and that provides recognition of AKI in the early stages. In this study, we aimed to evaluate early detection of the development of AKI with these molecules in patients who underwent coronary angiography. Materials and Methods: A total of 80 patients scheduled for coronary angiography (CAG) due to stable angina pectoris were evaluated. Before starting the processes and 6 hours after the procedure, levels of NGAL and Cystatin C in serum and urine, KIM-1 just in urine and additionally the level of the serum creatinine at 48 hours were investigated for early CIN. Results: Patients is divided into two groups: CIN-group and no-CIN group. CIN was observed in 10 patients. There was no significant difference in NGAL, KIM-1 and Cystatin C levels between the two groups. When the groups were assessed as the difference between its initial and 6. hours, the urinary NGAL (uNGAL) is significantly increased in both groups at 6. hours and serum NGAL (sNGAL) is significantly increased in no-CIN group. There were no significant differences in other biomarkers Conclusion: Only uNGAL showed significant results among the evulation of biomarkers that assess the development of CIN at an early stage while Other biomarkers not useful in evaluation the development of CIN. Keywords: Contrast Induced Nephropathy, NGAL, Cystatin C, KIM-1