Akademik Veri Yönetim Sistemi
ACTA MEDICA MEDITERRANEA, sa.1, ss.187-192, 2019 (SCI-Expanded, Scopus)
Introduction: Contrast-induced nephropathy (CIN) is a common cause of hospital-acquired acute kidney injury (AKI). Plasma neutrophil gelatinase-associated lipocalin (NGAL) appears to be a novel, non-invasive, early biomarker of AKI that was detected earlier than serum creatinine (SCr). We aimed to evaluate the effect of chronic renin-angiotensin system blockers (RASB) use on the development of CIN in diabetic patients undergoing cardiac procedures. Materials and methods: A total of 161 consecutive diabetic patients who underwent diagnostic and / or interventional coronary procedures were assessed for CIN. Patients were divided into two groups: Group I: RASB not stopped before the procedure (n=81), Group 11: RASB stopped before the procedure (n=80). Plasma NGAL levels and SCr were measured at baseline and postprocedural. Results: Contrast-induced-nephropathy was more prevalent in group I than in group 11 (25% vs. 11%, p=0.026, respectively). Multivariate analysis demonstrated that RASB use was 3.1 times more likely to have CIN than RASB discontinuing patients (95% CI: 1.25-8.19; p = 0.016). Other independent predictor of C/N was hypertension (OR: 9.15; 95% CI: 1.52-54.99; p = 0.025). Diabetic nephropathy tended to be related with the predicting of contrast induced nephropathy by multivariate analysis (OR: 239; 95% CI:0.92-6.21; p=0.07). Postprocedural plasma NGAL level was higher at 4. hour in CIN(+ ) patients compared to CIN(-) patients. Conclusion: The present study demonstrated that withholding RASBs prior to coronary procedures might prevent CIN in diabetic patients with normal renal function. NGAL level appears to be of diagnostic value earlier when compared to SCr for AKI after contrast exposure.