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Submitted: 19 Mar 2020
Accepted: 08 Jun 2020
ePublished: 25 Jun 2020
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J Nephropharmacol. 2021;10(1): e04.
doi: 10.34172/npj.2021.04
  Abstract View: 363
  PDF Download: 146

Original

Comparison of urinary KIM-1 and NGAL and plasma creatinine in patients undergoing coronary artery bypass graft surgery

Maryam Saeedi Ghaheh 1 ORCID logo, Saeed Mardani 1 * ORCID logo, Afsaneh Malekpour 2 ORCID logo, Farzaneh Kadkhodaei Elyaderani 1 ORCID logo, Fatemeh Salehi Choliche 1 ORCID logo, Nayereh Mortazavi 1 ORCID logo, Shadi Botshekan 2 ORCID logo

1 Department of Internal Medicine, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
*Corresponding author: Saeed Mardani, Email: Dr.s.mardani72@gmail.com

Abstract

Introduction: Serum creatinine level is currently being used as an indicator to detect acute kidney injury (AKI) after cardiac surgery, which is delayed and unreliable.

Objectives: This study was conducted to determine the AKI in patients undergoing coronary artery bypass graft (CABG) surgery by measurement of urinary creatinine and plasma kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL).

Patients and Methods: In this cross-sectional study, 96 patients undergoing CABG were divided based on their serum creatinine level of the fourth day after procedure into two groups of AKI (an increase of creatinine more than 0.3 mg/dl or more than 150 % of its baseline level) and non-AKI. In both groups urinary KIM-1 and urinary NGAL were measured on the first day of surgery (first 24 h).

Results: No significant difference was observed in baseline creatinine between the two groups (P>0.05). However postoperative serum creatinine, creatinine changes, urinary NGAL and KIM1 showed significant difference between the groups (P<0.05). Serum creatinine was positively correlated with KIM-1 (r = 0.666, P<0.001) and NGAL (r = 0.660, P<0.001). KIM-1 and NGAL had high ability to detect AKI [area under the ROC (receiver operating characteristic) curve of 0.929 and 0.838, respectively]. The NGAL at cut-off point of 97.4 had 86% sensitivity and 80% specificity and KIM-1 at cut-off point of 14.8 had 84% sensitivity and 89% specificity.

Conclusion: KIM-1 and NGAL had high ability to detect AKI. However, KIM-1 had higher detection ability than that of NGAL.

Keywords: Neutrophil gelatinase-associated lipocalin (NGAL), Acute renal injury, Coronary artery bypass graft surgery, Kidney injury molecule (KIM-1)

Implication for health policy/practice/research/medical education:

Acute kidney injury (AKI) is a common and serious condition, its diagnosis depends on serum creatinine, which is a delayed and unreliable indicator of AKI. In this study, postoperative creatinine, creatinine changes, urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary kidney injury molecule (KIM-1) were significantly higher in AKI patients than non-AKI patients. Serum creatinine was positively correlated with KIM-1 and NGAL. KIM-1 and NGAL had high ability to detect AKI. The availability of a suitable AKI biomarker could further revolutionize renal and critical care. However, further studies are needed for identification, validation, commercial development and acceptance of developed AKI biomarkers.

Please cite this paper as: Saeedi Ghaheh M, Mardani S, Malekpour A, Kadkhodaei Elyaderani F, Salehi Choliche F, Mortazavi N, Botshekan S. Comparison of urinary KIM-1 and NGAL and plasma creatinine in patients undergoing coronary artery bypass graft surgery. J Nephropharmacol. 2021;10(1):eo4. DOI: 10.34172/npj.2021.04.

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