Souza Denis F, Reis Samir S A, Botelho Roberto V, Ferreira-Filho Sebastião R
Department of Internal Medicine, Federal University of Uberlândia, Uberlândia, Brazil.
Nephron. 2015;129(2):84-90. doi: 10.1159/000368413. Epub 2015 Feb 6.
INTRODUCTION/AIMS: The Acute Kidney Injury Network classification is based on small increases in serum creatinine (sCr) for stage 1. This study investigated whether changes in the urinary concentration of neutrophil gelatinase-associated lipocalin (uNGAL) could predict small increases in sCr in patients undergoing coronary angiography.
The uNGAL was measured before contrast infusion and 2 and 4 h afterwards. Patients were divided into 2 subgroups: G1 (n = 103), where sCr increased by <0.3 mg/dl, and G2 (n = 22), where sCr increased by ≥0.3 mg/dl 48 h after the angiography. To determine the sensitivity and specificity for the absolute and relative variations of uNGAL, a receiver operating characteristic curve analysis was performed.
In G2, the uNGAL concentration increased over baseline values (15.9 vs. 9.2 ng/dl; p < 0.05), and it was also 2-fold higher in G2 versus G1 (15.9 vs. 8.0 ng/dl; p < 0.001). The uNGAL remains an independent predictor of the small increases in sCr, and, for an increase of 50% over baseline levels, it showed 60% sensitivity and 81% specificity.
Changes in uNGAL concentration 2 h after the infusion of contrast media showed marginal sensitivity to predict small increases in sCr.
引言/目的：急性肾损伤网络分类中1期是基于血清肌酐（sCr）的小幅升高。本研究调查了中性粒细胞明胶酶相关脂质运载蛋白（uNGAL）尿浓度的变化是否能预测接受冠状动脉造影患者的sCr小幅升高。
在注入造影剂前以及之后2小时和4小时测量uNGAL。患者被分为2个亚组：G1组（n = 103），造影后48小时sCr升高<0.3mg/dl；G2组（n = 22），造影后48小时sCr升高≥0.3mg/dl。为确定uNGAL绝对和相对变化的敏感性和特异性，进行了受试者工作特征曲线分析。
在G2组中，uNGAL浓度高于基线值（15.9对9.2ng/dl；p<0.05），且G2组比G1组高2倍（15.9对8.0ng/dl；p<0.001）。uNGAL仍然是sCr小幅升高的独立预测指标，对于超过基线水平50%的升高，其敏感性为60%，特异性为81%。
注入造影剂后2小时uNGAL浓度变化对预测sCr小幅升高的敏感性有限。
