Diagnostic Precision of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for the Early Detection of Contrast-Induced Acute Kidney Injury

International Journal of Medicine and Medical Sciences | Vol. 12, No. 7, July 2022 | pp. 49–56

DOI: 10.46882/2022/IJMMS/120049

Original Research Article

Diagnostic Precision of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for the Early Detection of Contrast-Induced Acute Kidney Injury

Charles O. Igwe¹, Rachel L. Sanon², Anthony D. Boateng¹*

¹Department of Radiology, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria.

²Department of Nephrology, Faculty of Health Sciences, Université de Ouagadougou, Ouagadougou, Burkina Faso.

Abstract:

Contrast-induced acute kidney injury (CI-AKI) elevates cardiovascular mortality following coronary angiography, but conventional serum creatinine is a slow diagnostic marker. This prospective cohort study evaluated the diagnostic accuracy of serum neutrophil gelatinase-associated lipocalin (sNGAL) compared to serum creatinine for the early detection of CI-AKI. We evaluated 140 adult patients with chronic kidney disease (baseline eGFR between 30 and 59 mL/min/1.73m²) undergoing elective coronary angiographic procedures. Serum NGAL was measured via chemiluminescent immunoassay at baseline, 4, 12, and 24 hours post-procedure, while serum creatinine was monitored daily for 3 days. CI-AKI was defined as a ≥ 25% or ≥ 44.2 μmol/L increase in serum creatinine from baseline within 48 hours. Twenty-four patients developed confirmed CI-AKI (17.1%). In the CI-AKI group, sNGAL levels rose significantly from a baseline of 84.5 ± 12.4 ng/mL to 185.4 ± 24.6 ng/mL at 4 hours post-procedure (p < 0.01), whereas serum creatinine variations were non-significant at this time point. Receiver Operating Characteristic (ROC) analysis showed that 4-hour sNGAL at a cutoff value of 140 ng/mL had a sensitivity of 91.7%, specificity of 86.2%, and an Area Under the Curve (AUC) of 0.92 (95% CI = 0.85–0.97). In contrast, 24-hour serum creatinine achieved an AUC of only 0.68. Serum NGAL serves as a highly sensitive and precise early diagnostic biomarker for contrast-induced renal injury, allowing for timely protective renal interventions long before creatinine clearance falls.

Keywords: Contrast-Induced Nephropathy, Acute Kidney Injury, Neutrophil Gelatinase-Associated Lipocalin, Biomarkers, Coronary Angiography, Renal Function

Manuscript Timeline: Received: April 02, 2022; Revised: May 11, 2022; Accepted: June 05, 2022; Published: July 12, 2022.

Citation: Igwe CO, Sanon RL, Boateng AD. Diagnostic Precision of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for the Early Detection of Contrast-Induced Acute Kidney Injury. International Journal of Medicine and Medical Sciences, 2022, 12(7): 49–56. DOI: 10.46882/2022/IJMMS/120049

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