URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (uNGAL) as an early biomarker for Contrast-Induced Acute Kidney Injury after Cardiac Catheterization
Khaled Mohamed Rezk;
Abstract
AKI is a major clinical problem in hospitalized patients. Effective treatment and early diagnosis of this syndrome are not currently available. NGAL is one of the most intensively investigated novel renal biomarkers with promising data from animal experiments and clinical studies comprising the populations at risk for AKI. Within minutes to a few hours after a renal insult, NGAL is induced in and released from the injured distal nephron. So, it appears to fulfill many characteristics of an appropriate 'real-time' biomarker for AKI detection.
Studies of large adult cohorts have revealed that contrast-induced AKI is the third most common cause of hospital-acquired AKI, accounting for approximately 11% of cases.
Approximately half of these cases are in subjects undergoing cardiac catheterization and angiography, and approximately a third follow computed tomography.
A variety of definitions of CIN are present in the literature. They most commonly consist of either a relative (25–100%) or absolute (0.3–1.0 mg/dL) increase in serum creatinine above baseline levels. It has been suggested that a change of 0.3 mg/dL is not statistically significant in many laboratories. The most commonly used definition of CIN, therefore, is either a relative increase in serum creatinine from baseline value of 25% or an absolute increase of 0.5 mg/dL within 48 to 72 hours after contrast exposure. Additionally, the creatinine elevation must not be attributable to other causes and must persist for 2 to 5 days. Treatment of CIN begins with identification of the injury and is similar for other causes of acute renal failure. Patients should be monitored by a nephrologist in an inpatient setting. Management typically involves careful monitoring of electrolytes, adjusting nutrition, and strict monitoring of body weight and fluid balance. Metabolic disturbances such as hyperphosphatemia can be
Studies of large adult cohorts have revealed that contrast-induced AKI is the third most common cause of hospital-acquired AKI, accounting for approximately 11% of cases.
Approximately half of these cases are in subjects undergoing cardiac catheterization and angiography, and approximately a third follow computed tomography.
A variety of definitions of CIN are present in the literature. They most commonly consist of either a relative (25–100%) or absolute (0.3–1.0 mg/dL) increase in serum creatinine above baseline levels. It has been suggested that a change of 0.3 mg/dL is not statistically significant in many laboratories. The most commonly used definition of CIN, therefore, is either a relative increase in serum creatinine from baseline value of 25% or an absolute increase of 0.5 mg/dL within 48 to 72 hours after contrast exposure. Additionally, the creatinine elevation must not be attributable to other causes and must persist for 2 to 5 days. Treatment of CIN begins with identification of the injury and is similar for other causes of acute renal failure. Patients should be monitored by a nephrologist in an inpatient setting. Management typically involves careful monitoring of electrolytes, adjusting nutrition, and strict monitoring of body weight and fluid balance. Metabolic disturbances such as hyperphosphatemia can be
Other data
| Title | URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (uNGAL) as an early biomarker for Contrast-Induced Acute Kidney Injury after Cardiac Catheterization | Other Titles | تقييم ليبوكالين النيتروفيل المرتبط بالجيلاتيناز فى البول كعامل بيولوجى مبكر للإعتلال الكلوى الحاد الصبغى بعد قسطرة القلب | Authors | Khaled Mohamed Rezk | Issue Date | 2016 |
Attached Files
| File | Size | Format | |
|---|---|---|---|
| G11603.pdf | 255.05 kB | Adobe PDF | View/Open |
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