Serum NGAL And Cystatin C In The Early Diagnosis Of Contrast Nephropathy

Background and objective: Contrast induced nephropathy(CIN)is a disease of iatrogenic renal function injury caused by contrast agent,but its pathogenesis is not completely clear,and there is no specific diagnosis and treatment methods.The key to the prevention of CIN is the clinical early diagnosis,and can put forward the appropriate treatment plan,so that it can significantly improve the prognosis of CIN.Current clinical diagnostic CIN traditional indicators of serum creatinine(Cr)levels are affected by many factors,such as age,gender,diet,weight,nutritional status and so on.Therefore,the serum Cr value was not the most sensitive and reliable index for early diagnosis of acute renal function damage.This clinical study is undergoing coronary artery interventional therapy before and after surgery collected blood samples from patients in hospital,and were followed by testing early prediction indexes of serum neutrophil gelatinase associated carrying lipoprotein(NGAL)and serum cystatin C(Cys C)and traditional diagnosis index of serum urea nitrogen(BUN)and serum CR values in the preoperative and postoperative changes of level,so that early predictive indexes of serum NGAL,serum cystatin C in CIN the early prediction and diagnosis of clinical value.Methods:Prospective data were collected from the coronary intervention in the heart catheterization laboratory of the People’s Hospital of Liaoning Province.Andthe 84 cases are hospitalized patients from October 2014 to February 2014.Blood samples were collected at 8 hours before operation and 24 hours after operation respectively.The changes of serum NGAL,serum Cysc,serum BUN,and serum Cr level before and after operation were detected.All data were measurement data,each index values shown as ?x±s in the changes of level before and after the surgery,the same index in changes before and after operation by paired t-test and at different time points of the indicator concentration changes using repeated measures analysis of variance(ANOVA).Results:1.Serum NGAL levels in interventional therapy after 8 hours began to rise,continued to postoperative 24 hours [after 8 hours is preoperative significantly increased(0.655 ± 2.068,P = 0.005),postoperative 24 hours compared with the preoperative significantly increased(1.920 ± 4.155,P = 0.001),24 hours after operation compared with postoperative 8 hours significantly increased(1.265±4.003,P = 0.005)];2.Serum cystatin C levels in interventional therapy after 8 hours began to increase,the postoperative 24 hours reach to the peak [after 8 hours is preoperative significantly increased(0.081±0.161,P = 0.001),postoperative 24 hours compared with the preoperative significantly increased(0.136±0.184,P = 0.000),24 hours after operation compared with postoperative 8 hours significantly increased(0.055±0.138,P=0.001)];3.Serum Cr levels involved in the 8 hours after surgery in the treatment of 24 hours compared with the preoperative elevated had no significant difference [after 8hours compared with the preoperative elevated no significant difference(1.430 ±9.783,P = 0.184)and postoperative 24 hours compared with the preoperative elevated(1.519 ± 10.990,P = 0.209)no significant difference,the postoperative 24 hours compared with postoperative 8 hours increased without significant difference(0.090±7.327,P=0.911)];4.Serum BUN Levels to intervene in the 8 hours after surgery in the treatment of24 hours compared with the preoperative elevated no significant difference[postoperative 8 hours compared with the preoperative increased significantdifference(0.086 ±1.841,P=0.668)and postoperative 24 hours compared with the preoperative elevated significantly(0.033 ± 1.756,P=0.864)and postoperative 24 hours compared with postoperative 8 hours increase without significant difference(0.054±1.936,P=0.800)].Conclusions : Serum NGAL and serum cystatin C within 8 hours after underwent coronary artery angiography and interventional treatment increased significantly,and thus can earlier tip acute renal function injury,thus becoming better for CIN the early prediction of the biochemical indexes and in early prediction of CIN in certain clinical value.