Predictive Value of Neutrophil Gelatinase-Associated Lipocalin for Contrast-Induced Acute Kidney Injury After Cardiac Catheterization: A Meta-analysis

Abstract Background Neutrophil gelatinase-associated lipocalin (NGAL) accumulates in cortical tubules in acute kidney injury (AKI) patients, with its levels associated with serum creatinine. However, the predictive value of NGAL level for contrast-induced acute kidney injury (CI-AKI) remains unclear...

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Published in:Canadian journal of cardiology 2016-08, Vol.32 (8), p.1033.e19-1033.e29
Main Authors: Wang, Kun, MD, Duan, Chong-yang, MD, Wu, Jun, MD, Liu, Yong, MD, Bei, Wei-jie, MD, Chen, Ji-yan, MD, FACC, FESC, He, Peng cheng, MD, Liu, Yuan-hui, MD, Tan, Ning, MD, FAPSIC, FESC
Format: Article
Language:English
Subjects:
Acute Kidney Injury - chemically induced
Acute Kidney Injury - diagnosis
Biomarkers - blood
Biomarkers - urine
Cardiac Catheterization
Cardiovascular
Contrast Media - adverse effects
Humans
Lipocalin-2 - blood
Lipocalin-2 - urine
Predictive Value of Tests
Sensitivity and Specificity
Time Factors
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Summary:Abstract Background Neutrophil gelatinase-associated lipocalin (NGAL) accumulates in cortical tubules in acute kidney injury (AKI) patients, with its levels associated with serum creatinine. However, the predictive value of NGAL level for contrast-induced acute kidney injury (CI-AKI) remains unclear. Methods A total of 1520 patients from 14 relevant studies retrieved from PUBMED, MEDLINE, EMBASE, Web of Science, ClinicalTrials.gov , Cochrane Library, and Google Scholar from the inception to November 2014 and 15 data sets were included. Results The pooled area under the curve of receiver operating characteristic analysis of NGAL for predicting CI-AKI was 0.93, and the diagnostic odds ratio, sensitivity, specificity, and median cutoff value were 42.54, 83.98%, 89.03%, and 52.4 ng/mL, respectively. Urine and serum/plasma NGAL levels performed similarly well in predicting CI-AKI, with somewhat better results obtained when the NGAL level was determined within 4 hours after exposure to contrast medium. Conclusions Patient nationality and definition of CI-AKI were important factors that affected the efficiency of NGAL level in predicting CI-AKI. Urine and serum/plasma NGAL levels appear to be promising biomarkers for early detection of CI-AKI after percutaneous coronary intervention or coronary angiography.
ISSN:0828-282X
1916-7075
DOI:10.1016/j.cjca.2015.09.011