Urinary KIM-1, NGAL and L-FABP for the diagnosis of AKI in patients with acute coronary syndrome or heart failure undergoing coronary angiography

作者：Torregrosa Isidro^*; Montoliu Carmina; Urios Amparo; Jesus Andres Costa Maria; Gimenez Garzo Carla; Juan Isabel; Jesus Puchades Maria; Luisa Blasco Maria; Carratala Arturo; Sanjuan Rafael; Miguel Alfonso

来源：Heart and Vessels, 2015, 30(6): 703-711.

DOI：10.1007/s00380-014-0538-z

• Acute kidney injury
• Biomarkers
• Coronary angiography
• Cardiac surgery
• KIM-1
• NGAL
• L-FABP

Acute kidney injury (AKI) is a common complication after coronary angiography. Early biomarkers of this disease are needed since increase in serum creatinine levels is a late marker. To assess the usefulness of urinary kidney injury molecule-1 (uKIM-1), neutrophil gelatinase-associated lipocalin (uNGAL) and liver-type fatty acid-binding protein (uL-FABP) for early detection of AKI in these patients, comparing their performance with another group of cardiac surgery patients. Biomarkers were measured in 193 patients, 12 h after intervention. In the ROC analysis, AUC for KIM-1, NGAL and L-FABP was 0.713, 0.958 and 0.642, respectively, in the coronary angiography group, and 0.716, 0.916 and 0.743 in the cardiac surgery group. Urinary KIM-1 12 h after intervention is predictive of AKI in adult patients undergoing coronary angiography, but NGAL shows higher sensitivity and specificity. L-FABP provides inferior discrimination for AKI than KIM-1 or NGAL in contrast to its performance after cardiac surgery. This is the first study showing the predictive capacity of KIM-1 for AKI after coronary angiography. Further studies are still needed to answer relevant questions about the clinical utility of biomarkers for AKI in different clinical settings.

• 出版日期2015-11