Diagnostic biomarker of contrast media induced kidney injury in elderly patients
  
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DOI:10.3724/SP.J.1264.2012.00212
Key words:constrast-induced nephropathy  diagnostic biomarker  elderly
Author NameAffiliationE-mail
WANG Zhaoxing, MA Qing, CHEN Haiping Division of Geriatric Nephrology, Medical Care Centre, Affiliated Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China chp3@sina.com 
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Abstract:
      Objective To explore the suitable biomarker for timely and accurate diagnosis of contrast media induced kidney injury in elderly patients by comparing the concentration of serum creatinine (SCr), serum cystatin C (CysC)and other biomarkers before and after the angiography. Methods Forty-one old patients aged over 60 years having undergone angiography were enrolled in this study. Before the angiography, 2h, 24h, 48h and 72h after the angiography, the SCr value were tested by enzymic method. The serum and urine sample were also collected to test the serum CysC, serum neutrophil gelatinase-associated lpipocalin (NGAL) and urine kidney injury molecule-1(KIM-1) value with enzyme linked immunosorbent assay (ELISA) method. The levels of the biomarkers from the different time points were compared and analyzed. Results Contrast-induced nephropathy (CIN) occurred in 1 of 41 enrolled patients (2.44%). Acute kidney injury (AKI) occurred in 3 of 41 enrolled patients (7.32%). The concentration of serum CysC increased by over 25% in 27 patients after angiography (65.9%). Before and after angiography, the levels of SCr had no significant change. The levels of serum CysC elevated significantly at 24h and 48h after angiography. Serum NGAL, urine NGAL and urine KIM-1 elevated significantly in the patients with CysC increased by over 25%. Conclusion The traditional diagnostic biomarker of CIN is not suitable for elderly patients. CysC may be a timely and accurate biomarker for the diagnosis of contrast media induced kidney injury in elderly patients.
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