Heart and Vessels

, Volume 29, Issue 2, pp 191–197 | Cite as

Elevation of urinary liver-type fatty acid-binding protein as predicting factor for occurrence of contrast-induced acute kidney injury and its reduction by hemodiafiltration with blood suction from right atrium

  • Hiromasa Katoh
  • Tsuyoshi Nozue
  • Yuya Kimura
  • Sei Nakata
  • Taku Iwaki
  • Mitsuhiro Kawano
  • Masa-aki Kawashiri
  • Ichiro Michishita
  • Masakazu Yamagishi
Original Article

Abstract

Although contrast-induced acute kidney injury (CI-AKI) has a great impact on patients’ prognosis, few data exist regarding predictors of CI-AKI in patients with severe renal dysfunction who have undergone contrast angiography. Therefore, we prospectively studied 25 patients with renal dysfunction, which was defined as the estimated glomerular filtration rate (eGFR) level <45 ml/min/1.73 m2, undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). We performed hemodiafiltration with blood suction from the right atrium (RA-HDF). The mean level of urinary liver-type fatty acid-binding protein (L-FABP) at baseline was significantly higher in the CI-AKI group than in the non-CI-AKI group (59.8 ± 45.6 vs 13.4 ± 11.9 μg/gCr, P = 0.0003). Multivariate regression analysis demonstrated that baseline urinary L-FABP was an independent significant predictor of CI-AKI (β = 0.741, P = 0.013). Receiver-operating characteristic analysis showed that baseline urinary L-FABP exhibited 100 % sensitivity and 81.8 % specificity for predicting CI-AKI when the cutoff value was defined as 19.0 μg/gCr. Interestingly, the incidence of CI-AKI after CAG or PCI was reduced in the RA-HDF group in a comparison with 41 control patients (12 % vs 27 %) with eGFR level <45 ml/min/1.73 m2 who underwent PCI before the introduction of RA-HDF. In conclusion, baseline L-FABP levels can be a predictor for occurrence of CI-AKI. We suggest that RA-HDF may prevent the development of CI-AKI in patients with severe renal dysfunction undergoing coronary procedures, although further large-scale prospective study is necessary to confirm our conclusions.

Keywords

Contrast-induced acute kidney injury Coronary procedure Hemodiafiltration Liver-type fatty acid-binding protein 

References

  1. 1.
    McCullough PA, Wolyn R, Rocher LL, Levin RN, O’Neill WW (1997) Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 103:368–375PubMedCrossRefGoogle Scholar
  2. 2.
    Gruberg L, Mintz GS, Mehran R, Gangas G, Lansky AJ, Kent KM, Pichard AD, Satler LF, Leon MB (2000) The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal failure. J Am Coll Cardiol 36:1542–1548PubMedCrossRefGoogle Scholar
  3. 3.
    Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, Singh M, Bell MR, Barsness GW, Mathew V, Garratt KN, Holmes DR Jr (2002) Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 105:2259–2264PubMedCrossRefGoogle Scholar
  4. 4.
    Ting HH, Tahirkheli NK, Berger PB, McCarthy JT, Timimi FK, Mathew V, Rihal CS, Hasdai D, Holmes DR Jr (2001) Evaluation of long-term survival after successful percutaneous coronary intervention among patients with chronic renal failure. Am J Cardiol 87:630–633PubMedCrossRefGoogle Scholar
  5. 5.
    Best PJ, Lennon R, Ting HH, Bell MR, Rihal CS, Holmes DR, Berger PB (2002) The impact of renal insufficiency on clinical outcomes in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol 39:1113–1119PubMedCrossRefGoogle Scholar
  6. 6.
    Levy EM, Viscoli CM, Horwitz RI (1996) The effect of acute renal failure on mortality: a cohort analysis. JAMA 275:1489–1494PubMedCrossRefGoogle Scholar
  7. 7.
    Gruberg L, Mehran R, Dangas G, Mintz GS, Waksman R, Kent KM, Pichard AD, Satler LF, Wu H, Leon MB (2001) Acute renal failure requiring dialysis after percutaneous coronary interventions. Catheter Cardiovasc Interv 52:409–416PubMedCrossRefGoogle Scholar
  8. 8.
    Ogita M, Sakakura K, Nakamura T, Funayama H, Wada H, Naito R, Sugawara Y, Kubo N, Ako J, Momomura S (2012) Association between deteriorated renal function and long-term clinical outcomes after percutaneous coronary intervention. Heart Vessels 27:460–467PubMedCrossRefGoogle Scholar
  9. 9.
    Investigators ACT (2011) Acetylcysteine for prevention of renal outcomes in patients undergoing coronary and peripheral vascular angiography: main results from the randomized Acetylcysteine for Contrast-induced nephropathy Trial (ACT). Circulation 124:1250–1259CrossRefGoogle Scholar
  10. 10.
    Matejka J, Varvarovsky I, Vojtisek P, Herman A, Rozsival V, Borkova V, Kvasnicka J (2010) Prevention of contrast-induced acute kidney injury by theophylline in elderly patients with chronic kidney disease. Heart Vessels 25:536–542PubMedCrossRefGoogle Scholar
  11. 11.
    Khoury Z, Schlicht JR, Como J, Karschner JK, Shapiro AP, Mook WJ, Weber RJ (1995) The effect of prophylactic nifedipine on renal function in patients administered contrast media. Pharmacotherapy 15:59–65PubMedGoogle Scholar
  12. 12.
    Mueller C, Buerkle G, Buettner HJ, Petersen J, Perruchoud AP, Eriksson U, Marsch S, Roskamm H (2002) Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med 162:329–336PubMedCrossRefGoogle Scholar
  13. 13.
    Vogt B, Ferrari P, Schonholzer C, Marti HP, Mohaupt M, Wiederkehr M, Cereghetti C, Serra A, Huynh-Do U, Uehlinger D, Frey FJ (2001) Prophylactic hemodialysis after radiocontrast media in patients with renal insufficiency is potentially harmful. Am J Med 111:692–698PubMedCrossRefGoogle Scholar
  14. 14.
    Reinecke H, Fobker M, Wellmann J, Becke B, Fleiter J, Heitmeyer C, Breithardt G, Hense HW, Schaefer RM (2007) A randomized controlled trial comparing hydration therapy to additional hemodialysis or N-acetylcysteine for the prevention of contrast medium-induced nephropathy: the Dialysis-versus-Diuresis (DVD) Trial. Clin Res Cardiol 96:130–139PubMedCrossRefGoogle Scholar
  15. 15.
    Marenzi G, Marana I, Lauri G, Assanelli E, Grazi M, Campodonico J, Trabattoni D, Fabbiocchi F, Montorsi P, Bartorelli AL (2003) The prevention of radiocontrast-agent-induced nephropathy by hemofiltration. N Engl J Med 349:1333–1340PubMedCrossRefGoogle Scholar
  16. 16.
    Michishita I, Fujii Z (2006) A novel contrast removal system from the coronary sinus using an adsorbing column during coronary angiography in a porcine model. J Am Coll Cardiol 47:1866–1870PubMedCrossRefGoogle Scholar
  17. 17.
    Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A, Collaborators developing the Japanese equation for estimated GFR (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53:982–992PubMedCrossRefGoogle Scholar
  18. 18.
    James MT, Ghali WA, Knudtson ML, Ravani P, Tonelli M, Faris P, Pannu N, Manns BJ, Klarenbach SW, Hemmelgarn BR, Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators (2011) Associations between acute kidney injury and cardiovascular and renal outcomes after coronary angiography. Circulation 123:409–416PubMedCrossRefGoogle Scholar
  19. 19.
    Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, Mintz GS, Lansky AJ, Moses JW, Stone GW, Leon MB, Dangas G (2004) A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention. J Am Coll Cardiol 44:1393–1399PubMedGoogle Scholar
  20. 20.
    Hayashi T, Nitta K, Hatano M, Nakauchi M, Nihei H (1999) The serum cystatin C concentration measured by particle-enhanced immunonephelometry is well correlated with inulin clearance in patients with various types of glomerulonephritis. Nephron 82:90–92PubMedCrossRefGoogle Scholar
  21. 21.
    Veerkamp JH, Peeters RA, Maatman RG (1991) Structural and functional features of different types of cytoplasmic fatty acid-binding proteins. Biochim Biophys Acta 1081:1–24PubMedCrossRefGoogle Scholar
  22. 22.
    Kamijo A, Kimura K, Sugaya T, Yamanouchi M, Hikawa A, Hirano N, Hirata Y, Goto A, Omata M (2004) Urinary fatty acid-binding protein as a new clinical marker of the progression of chronic renal disease. J Lab Clin Med 143:23–30PubMedCrossRefGoogle Scholar
  23. 23.
    Kamijo A, Sugaya T, Hikawa A, Okada M, Okumura F, Yamanouchi M, Honda A, Okabe M, Fujino T, Hirata Y, Omata M, Kaneko R, Fujii H, Fukamizu A, Kimura K (2004) Urinary excretion of fatty acid-binding protein reflects stress overload on the proximal tubules. Am J Pathol 165:1243–1255PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Nakamura T, Sugaya T, Node K, Ueda Y, Koide H (2006) Urinary excretion of liver-type fatty acid-binding protein in contrast medium-induced nephropathy. Am J Kidney Dis 47:439–444PubMedCrossRefGoogle Scholar
  25. 25.
    Kato K, Sato N, Yamamoto T, Iwasaki YK, Tanaka K, Mizuno K (2008) Valuable markers for contrast-induced nephropathy in patients undergoing cardiac catheterization. Circ J 72:1499–1505PubMedCrossRefGoogle Scholar
  26. 26.
    Artunc FH, Fischer IU, Risler T, Erley CM (2005) Improved estimation of GFR by serum cystatin C in patients undergoing cardiac catheterization. Int J Cardiol 102:173–178PubMedCrossRefGoogle Scholar
  27. 27.
    Cruz DN, Goh CY, Marenzi G, Corradi V, Ronco C, Perazella MA (2012) Renal replacement therapies for prevention of radiocontrast-induced nephropathy: a systematic review. Am J Med 125:66–78PubMedCrossRefGoogle Scholar
  28. 28.
    Russo D, Minutolo R, Cianciaruso B, Memoli B, Conte G, De Nicola L (1995) Early effects of contrast media on renal hemodynamics and tubular function in chronic renal failure. J Am Soc Nephrol 6:1451–14588PubMedGoogle Scholar
  29. 29.
    Schindler R, Stahl C, Venz S, Ludat K, Krause W, Frei U (2001) Removal of contrast media by different extracorporeal treatments. Nephrol Dial Transplant 16:1471–1474PubMedCrossRefGoogle Scholar
  30. 30.
    Klarenbach SW, Pannu N, Tonelli MA, Manns BJ (2006) Cost-effectiveness of hemofiltration to prevent contrast nephropathy in patients with chronic kidney disease. Crit Care Med 34:1044–1051PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Hiromasa Katoh
    • 1
  • Tsuyoshi Nozue
    • 1
  • Yuya Kimura
    • 1
  • Sei Nakata
    • 1
  • Taku Iwaki
    • 1
  • Mitsuhiro Kawano
    • 2
  • Masa-aki Kawashiri
    • 3
  • Ichiro Michishita
    • 1
  • Masakazu Yamagishi
    • 3
  1. 1.Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai HospitalFederation of National Public Service Personnel Mutual AssociationsYokohamaJapan
  2. 2.Division of Rheumatology and NephrologyKanazawa University Graduate School of MedicineKanazawaJapan
  3. 3.Division of Cardiovascular MedicineKanazawa University Graduate School of MedicineKanazawaJapan

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