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Urinary KIM-1, NGAL and L-FABP for the diagnosis of AKI in patients with acute coronary syndrome or heart failure undergoing coronary angiography

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Abstract

Acute kidney injury (AKI) is a common complication after coronary angiography. Early biomarkers of this disease are needed since increase in serum creatinine levels is a late marker. To assess the usefulness of urinary kidney injury molecule-1 (uKIM-1), neutrophil gelatinase-associated lipocalin (uNGAL) and liver-type fatty acid-binding protein (uL-FABP) for early detection of AKI in these patients, comparing their performance with another group of cardiac surgery patients. Biomarkers were measured in 193 patients, 12 h after intervention. In the ROC analysis, AUC for KIM-1, NGAL and L-FABP was 0.713, 0.958 and 0.642, respectively, in the coronary angiography group, and 0.716, 0.916 and 0.743 in the cardiac surgery group. Urinary KIM-1 12 h after intervention is predictive of AKI in adult patients undergoing coronary angiography, but NGAL shows higher sensitivity and specificity. L-FABP provides inferior discrimination for AKI than KIM-1 or NGAL in contrast to its performance after cardiac surgery. This is the first study showing the predictive capacity of KIM-1 for AKI after coronary angiography. Further studies are still needed to answer relevant questions about the clinical utility of biomarkers for AKI in different clinical settings.

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Acknowledgments

This research was supported by grants from Ministerio de Ciencia e Innovacion of Spain [PS09/00806 (CM), PI10/01434 (AM) and PI12/00884 (CM)] co-financing by the European Fund for Regional Development (FEDER); from Consellería de Educación de la Generalitat Valenciana (ACOMP/2009/191 and ACOMP/2012/056 to CM) and Sanitat (AP-028/10, AP-087/11 to CM). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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Authors and Affiliations

  1. Servicio de Nefrología, Hospital Clínico Universitario de Valencia, Av Blasco Ibáñez 17, 46010, Valencia, Spain

    Isidro Torregrosa, Isabel Juan, María Jesús Puchades & Alfonso Miguel

  2. Departamento de Medicina, Universidad de Valencia, Valencia, Spain

    Isidro Torregrosa, María Jesús Puchades & Alfonso Miguel

  3. Fundación Investigación Clínico de Valencia Instituto de Investigación Sanitaria, INCLIVA, Valencia, Spain

    Carmina Montoliu, Amparo Urios & María Jesús Andrés-Costa

  4. Departamento de Patología, Sección Histología, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain

    Carmina Montoliu

  5. Laboratorio de Neurobiología, Centro Investigación Príncipe Felipe, Valencia, Spain

    Carla Giménez-Garzó

  6. Unidad Coronaria, Hospital Clínico Universitario de Valencia, Valencia, Spain

    María Luisa Blasco & Rafael Sanjuán

  7. Laboratorio de Bioquímica Clínica y Patología Molecular, Hospital Clínico Universitario de Valencia, Valencia, Spain

    Arturo Carratalá

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  1. Isidro Torregrosa
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  10. Rafael Sanjuán
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  11. Alfonso Miguel
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Correspondence to Isidro Torregrosa.

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Torregrosa, I., Montoliu, C., Urios, A. et al. Urinary KIM-1, NGAL and L-FABP for the diagnosis of AKI in patients with acute coronary syndrome or heart failure undergoing coronary angiography. Heart Vessels 30, 703–711 (2015). https://doi.org/10.1007/s00380-014-0538-z

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