Published in:
Open Access
01-07-2015 | Contrast Media
No increase in Kidney Injury Molecule-1 and Neutrophil Gelatinase-Associated Lipocalin excretion following intravenous contrast enhanced-CT
Authors:
Judith Kooiman, Wilke R. van de Peppel, Yvo W. J. Sijpkens, Harald F. H. Brulez, P. M. de Vries, Mioara A. Nicolaie, H. Putter, Menno V. Huisman, W. van der Kooij, Cees van Kooten, Ton J. Rabelink
Published in:
European Radiology
|
Issue 7/2015
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Abstract
Objectives
To analyze kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (N-GAL) excretion post-intravenous contrast enhanced-CT (CE-CT) in patients with chronic kidney disease (CKD).
Methods
Patients were enrolled in a trial on hydration regimes to prevent contrast-induced acute kidney injury (CI-AKI). Blood and urine samples were taken at baseline, 4 – 6, and 48 – 96 h post CE-CT. Urinary KIM-1 and N-GAL values were normalized for urinary creatinine levels, presented as medians with 2.5 – 97.5 percentiles.
Results
Of the enrolled 511 patients, 10 (2 %) were lost to follow-up. CI-AKI occurred in 3.9 % of patients (20/501). Median KIM-1 values were 1.2 (0.1 – 7.7) at baseline, 1.3 (0.1 – 8.6) at 4 – 6 h, and 1.3 ng/mg (0.1 – 8.1) at 48 – 96 h post CE-CT (P = 0.39). Median N-GAL values were 41.0 (4.4 – 3,174.4), 48.9 (5.7 – 3,406.1), and 37.8 μg/mg (3.5 – 3,200.4), respectively (P = 0.07). The amount of KIM-1 and N-GAL excretion in follow-up was similar for patients with and without CI-AKI (P-value KIM-1 0.08, P-value N-GAL 0.73). Neither patient characteristics at baseline including severe CKD, medication use, nor contrast dose were associated with increased excretion of KIM-1 or N-GAL during follow-up.
Conclusion
KIM-1 and N-GAL excretion were unaffected by CE-CT both in patients with and without CI-AKI, suggesting that CI-AKI was not accompanied by tubular injury.
Key Points
• KIM-1 and N-GAL excretion were unaffected by intravenous contrast-enhanced CT (CE-CT).
• Patient or procedure characteristics were not associated with increased KIM-1 or N-GAL excretion.
• Performance of CE-CT in CKD patients is likely to be safe.