Early Prediction Biomarkers of Contrast Induced Acute Kidney Injury-A single Center experience - See more at: http://www.journalijar.com/article/8365/early-prediction-biomarkers-of-contrast-induced-acute-kidney-injury-a-single-center-experience/#sthash.8OYVmR1t.dpuf

Background: Contrast-induced acute kidney injury (CI-AKI) representing the third most common cause of hospital acquired AKI. As serum creatinine (SCr) is an unreliable indicator of acute changes in renal function thus the need for early sensitive biomarkers to detect AKI of utmost value. Urinary Liver type fatty acid binding protein (uL-FABP) and plasma Cystatin C (CysC) is a newly emerging ones. Objective: To evaluate the significance of urinary L-FABP and plasma Cystatin as early prediction biomarkers of contrast induced AKI. Patients and methods: This study comprised a total of 33 patients divided into two main groups; Group I: 16 patients underwent coronary angiography for diagnostic and therapeutic purposes and Group II: 17 patients underwent computerized tomography (CT) for various purposes using intravenous (IV) contrast (high osmolar) media (CM). Then the patients reclassified into 2 new subgroups; AKI and non AKI groups accordinting to the change in SCr 24 hours (hs) after CM administration. Full clinical examination, routine investigations and estimation of urinary L-FABP and p- CysC were done. Results: the basal value of urinary L-FABP and p-CysC was significantly higher in AKI versus non AKI groups. AUC of u L-FABP = 0.837 (95%CI; 0.673 ? 1.001); AUC of p-CysC = 0.742 (95%CI; 0.600 ? 0.925). Six hs post contrast, both p- CysC and urinary L-FABP showed a highly statistically significant elevation at 6 hours in AKI group as compared to non AKI group, while there was no statistically significant difference in SCr, which showed significant elevation only after 24 hours. AUC of urinary L-FABP =1 (95%CI; 1 ? 1); AUC of p-CysC =1 (95%CI; 1 ? 1).There was significant positive correlation between uL-FABP and both p-CysC and amount of IV contrast (r=0.59, p<0.05 &r =0.53, p<0.05) respectively, negative correlation regarding estimated glomerular filtration rate (eGFR) (r=-0.52, p <0.5), whereas no significant correlations regarding SCr. Twenty four hs post contrast ,there was significant positive correlations between uL-FABP and each of p- CysC, contrast volume and SCr(r=0.61, p<0.05, r= 0.56,p<0.05, &r=0.58, p<0.05) respectively , but negative correlation regarding eGFR(r=-0.52, p<0.05) in AKI group. Conclusion: Urinary L-FABP and plasma Cystatin C can be considered as predictive biomarkers of contrast induced nephropathy (AKI), basally before contrast exposure and as early as six hours post contrast administration instead of serum creatinine, clearly, as these biomarkers levels start to rise earlier and in advance before any significant change in serum creatinine. - Seemore at: