ESPN 50th Annual Meeting

ESPN 2017


 
Comparison between NGAL, cystatine C and FAB urinary excretion as a markers of an acute kidney injury after contrast administration.
DARIA TOMCZYK 1 ANNA JANDER 1 TOMASZ MOSZURA 2 PAWEł DRYżEK 2 SEBASTIAN GóRECZNY 2 EWA GłOWACKA 3 JOLANTA ROMAK 3 MARCIN TKACZYK 1

1- POLISH MOTHERS MEMORIAL HOSPITAL RESEARCH INSTITUTE, PEDIATRICS IMMUNOLOGY AND NEPHROLOGY DEPARTMENT
2- POLISH MOTHERS MEMORIAL HOSPITAL RESEARCH INSTITUTE, CARDIOLOGY DEPARTMENT
3- POLISH MOTHERS MEMORIAL HOSPITAL RESEARCH INSTITUTE, LABORATORY DIAGNOSTICS CENTER
 
Introduction:

Prevention of pediatric contrast nephropathy might be challenging because of the lack of early and widely available biochemical markers to detect acute kidney injury (AKI). RIFLE score has proven its role in epidemiological analyses with less bedsite significance. Newer and more sensitive markers were postulated to increase the rate of early detection and to improve prevention of AKI. We aimed to compare the changes in urinary excretion of neutrophil gelatinase (uNGAL), cystatin C (uCysC) and liver-type fatty acid-binding protein(L-FAB) after administration of contrast media during cardiac catheterisation in children.

Material and methods:

The study group consisted of 50 children (35 boys and 15 girls) with congenital heart defects qualified for the scheduled cardiac catheterisation. Median age was 53 months (range 0-18 y). Patients with preexisting renal injury or malformations of the urinary tract were excluded. The study was granted by Polish Mothers Memorial Hospital Reserach Institute (grant 2014/IV/42-GW) Biochemical markers were analysed in absolute values and in relation to urine creatinine. Samples were collected before the procedure and in the 2,6,24 and 48 hour after contrast injection.

Results:

Significant changes were noticed in the excretion of uCysC, NGAL/Cr and CysC/Cr ratio. NGAL/Cr ratio rose in the 2 hour after contrast administration with reduction after 6 hours (Me: 9,42 vs 4,91). Significant rise in the urinary CysC and CysC/Cr ratio were noted only after 48 h. L-FAB concentration was below the detection threshold in the majority of patients. Only 21 children had it above the threshold after 24h. A correlation was detected between contrast media dose and urinary CysC (R=0,42; p<0,05) at the 48 h time point.

Conclusions:

Based on the results of the study, we postulate that NGAL and CysC might be considered as promissing urinary markers of contrast induced AKI. NGAL proved to be more sensitive in first hours after invasive procedures.