Urinary liver-type fatty acid-binding protein level as a predictive biomarker of contrast-induced acute kidney injury

European Journal of Clinical Investigation, 05/03/2012

Manabe K et al. – Urinary Liver–type fatty acid–binding protein (L–FABP) level is useful for predicting the onset of Contrast–induced acute kidney injury (CI–AKI) before contrast medium exposure.

Methods

  • The authors performed a prospective study of 220 consecutive patients with chronic kidney disease who underwent elective catheterization [serum creatinine (Cr) ≥ 1.2 mg/dL (106 M)].
  • Serum Cr and L–FABP levels were measured immediately before and 1 and 2 days after the procedure.
  • CI–AKI was defined as an increase in serum Cr level of ≥ 0.3 mg/dL within 48 h after the procedure.

Results

  • The authors observed the development of CI–AKI in 19 patients (8.6%).
  • Urinary L–FABP levels were significantly higher in patients with CI–AKI than those without CI–AKI before contrast medium exposure.
  • Receiver operating characteristic analysis showed that baseline urinary L–FABP level exhibited 82% sensitivity and 69% specificity, at a cut–off value of 24.5 μ g/g Cr.
  • Using multivariate analysis, the authors found that independent predictors of CI–AKI development were L–FABP level of ≥ 24.5 μ g/g Cr [odds ratio (OR): 9.10; 95% confidence interval (CI), 3.20–28•9], and left ventricular ejection fraction ≤ 40% (OR, 3.42; 95% CI, 1.07–10.8).

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