An early predictive biomarker of contrast-induced acute kidney injury

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Background :Urinary liver-type fatty acid-binding protein (L-FABP) is an intracellular carrier of free fatty acids, expressed in kidney proximal tubules. We examined whether urinary L-FABP is an early predictive biomarker of contrast-induced acute kidney injury (CI-AKI).Methods :We measured urinary L-FABP in 220 patients with creatinine (Cr)≧1.2 mg/dl (106 mol/l) scheduled for coronary angiography or angioplasty. Urinary L-FABP was measured before and after contrast agent administration.Results :CI-AKI developed in 19 patients (8.6%). There were no significant inter-group differences in serum Cr, estimated glomerular filtration rate, urinary N-acetyl-beta-D-glucosaminidase or β2-microglobulin (β2-MG) before contrast agent administration. The only significant pre-procedure difference was in L-FABP (17.7±33.3 vs. 49.8±53.6 ; P=0.005). At 24 and 48 hours post-procedure, all markers except urinaryβ2-MG differed significantly between the two groups. Multivariate analysis revealed L-FABP≧24.5 μg/g Cr (P<0.001 ; odds ratio [OR] : 9.10 ; 95% confidence interval [CI] : 3.20-28.9) and left ventricular ejection fraction≦40% (p=0.038 ; OR : 3.42 ; 95% CI : 1.07-10.8) to independently predict CI-AKI.Conclusions :Urinary L-FABP provides an important information for predicting CI-AKI after contrast agent administration