Evaluation Of The Value About Urine Fibrinogen In Early Stage Contrast-induced Nephropathy

Objective:We evaluated the time cross variation of urine fibrinogen levels in patients exposed to contrast media.Then we analyzed its predictive value and several related risk factors for contrast-induced nephropathy.Method:One hundred inpatients exposed to contrast media from The Second Hospital Of Shan’xi Medical University were enrolled in this prospective study.Urine Fg were measured 2hours before and 2 、 12 、 24 hours after contrast media exposure.Serum creatine were measured 24 hours before and 48 hours after contrast media exposure.Statistics analysis were conducted by ANOVA、Pearson chi-square test、Fisher probabilities in 2*2 table data,Pearson correlation、Spearman correlation、ROC(receiver operating characteristic curve)as needed.Results:The incidence of CIN was 6%. Urine Fg levels elevated as early as 2 hours after exposure, significantly higher at 12 hours, and reduced to baseline after 24 hours.Urine Fg levels at 12 and 24 hours were significantly higher in patients developed CIN than patients without CIN. Urine Fg levels after 12、24 hours were positively correlated with SCr levels after 48 hours in patients with CIN(r=0.245,P=0.017; r=0.241,P=0.019). ROC curve analysis showed that the AUC of Urine Fg levels after 12 hours was 0.739, when cut-off value was set at 12.16ng/ml, the sensitivity and specificity were 66.7% and 73.4%,respectively. Risk factors for CIN include kidney insufficiency(c2=14.93,P<0.05),hyperlipemia(c2=3.04,P<0.05), infection(c2=4.54,P<0.05), age ≥70years(c2=3.13,P<0.05),contrast media dose 150-300ml(c2=5.42,P<0.05).Conclusions:Urine Fg levels elevated as early as 2 hours after contrast media exposure,would be a potential biomarker for contrast-induced kidney injury. Patients with Kidney insufficiency,hyperlipemia, infection,age≥70years,contrast media dose≥150ml are high risk populations for CIN.