Predictive analysis of UACR combined with serum KIM-1 and NGAL on postoperative contrast-induced nephropathy in patients with coronary heart disease

ObjectiveTo investigate the evaluation value of urine micro-albumin/urinary creatinine ratio(UACR) combined with serum kidney injury molecule-1(KIM-1) and neutrophil gelatinase-associated lipocalin(NGAL) on postoperative contrast-induced nephropathy(CIN) in patients with coronary heart disease.

MethodsOne hundred and sixty-two patients with coronary heart disease were selected.All patients underwent coronary angiography and percutaneous coronary intervention.According to the occurrence of CIN after operation, they were divided into CIN group(22 cases) and non-CIN group(140 cases).The baseline data, UACR, serum KIM-1 and NGAL levels at 24 h after operation were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors of CIN.Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of UACR, KIM-1 and NGAL in predicting CIN.

ResultsThe levels of NGAL, serum KIM-1, UACR and preoperative UCr of CIN patients 24 h after operation were significantly higher than those in non-CIN group, while preoperative eGFR was significantly lower than that in control group(P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that the increased levels of UACR, KIM-1, NGAL were the risk factor for CIN(P < 0.01).ROC curve analysis showed that the area under the curve for NGAL, KIM-1, UACR and the combined diagnosis to predict CIN were 0.826, 0.801, 0.790, 0.886, the area under the curve of the combined diagnosis to predict CIN was significantly higher than that in the single diagnosis(P < 0.05).

ConclusionsUACR, serum KIM-1 and NGAL are the independent risk factors for CIN in patients with coronary heart disease after surgery.High-risk patients with CIN are all at a high level in UACR, serum KIM-1 and NGAL.The combined prediction of the three indicators can improve the predictive value of CIN.