Urinary and Serum Biomarkers after Cardiac Catheterization in Diabetic Patients with Stable Angina and without Severe Chronic Kidney Disease
Urinary and Serum Biomarkers after Cardiac Catheterization in Diabetic Patients with Stable Angina and without Severe Chronic Kidney Disease
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DOI：
10.3109/08860220903216113
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发表时间：
2009-01-01
期刊：
影响因子：
3
通讯作者：
Dobrzycki, Slawomir
中科院分区：
文献类型：
--
作者：
Malyszko, Jolanta;Bachorzewska-Gajewska, Hanna;Dobrzycki, Slawomir
背景/目的。不同的血清和尿液生物标志物最近被提出作为急性肾损伤的标志物。我们检验了NGAL和其他生物标志物是否可以作为对比剂肾病（CIN）的早期生物标志物的假设，在接受心导管插管的血清肌酐正常的糖尿病患者中，与非糖尿病患者相比。方法。在心导管插管前及术后2、4、8、24和48小时检测血清、尿NGAL、胱抑素C、尿肾损伤分子-1 （KIM-1）、白细胞介素-18 （IL-18）和肝型脂肪酸结合蛋白（L-FABP）。结果。我们发现两组患者在心导管置管后2、4和8小时血清NGAL显著升高，在心导管置管后4、8和24小时尿NGAL和IL-18显著升高。两组血清胱抑素C均在心导管置管后8 h显著升高，24 h达到峰值，48 h后下降。L-FABP和KIM-1在心导管置管后24、48小时显著升高。结论。在接受心导管置入术的糖尿病和非糖尿病患者中，CIN同样普遍。NGAL似乎是一个潜在的早期肾毒性标志物和造影剂肾病的预测因子。这在即将到来的心导管短时间住院治疗中尤为重要。
Background/Aims. Different serum and urinary biomarkers have been recently proposed to serve as markers of acute kidney injury. We tested the hypothesis whether NGAL and other biomarkers could represent an early biomarker of contrast nephropathy (CIN) in diabetic patients with normal serum creatinine undergoing cardiac catheterization in comparison with nondiabetic patients. Methods. Serum, urinary NGAL, cystatin C, urinary kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and liver-type fatty acid binding protein (L-FABP) were evaluated before and 2, 4, 8, 24, and 48 hours after cardiac catheterization using commercially available kits. Results. In both groups we found a significant rise in serum NGAL after 2, 4, and 8 hours, and in urinary NGAL and IL-18 after 4, 8, and 24 hours after cardiac catheterization. Serum cystatin C increased significantly 8 hours, reaching peak 24 hours after cardiac catheterization in both groups, and then decreased after 48 hours. L-FABP and KIM-1 increase significantly after 24 and 48 hours after cardiac catheterization. Conclusions. CIN was similarly prevalent in both diabetic and non-diabetic patients undergoing cardiac catheterization. NGAL seems to be a potential early marker for nephrotoxicity and predictor of contrast nephropathy. It is particularly important in the upcoming setting of short-time hospitalizations for cardiac catheterization.