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ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 3  |  Page : 154-161

Urinary liver-type fatty acid binding protein predicts renal angina in patients undergoing cardiac angiography: comparison with intrarenal arterial duplex


Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Hossam Sherif
Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo 11451
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_32_17

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Background Patients undergoing cardiac angiography may suffer from acute kidney injury (AKI) due to the effect of the contrast medium. Different biomarkers described the clinical condition and had led to concepts like subclinical AKI or renal angina (RA). Objective Detection of the usefulness of the biomarker urinary liver-type fatty acid binding protein (L-FABP) which increases along with renal tubular hypoxia, in early prediction of RA in patients subjected to coronary angiography (CA). Patients and methods Forty patients (54.10±9.13 years, 34 males) routinely scheduled for CA were included. The risk for AKI was evaluated, and the renal function was assessed using RIFLE (risk, injury, failure, loss, and end stage kidney) criteria. L-FABP was detected on admission and 4 h after CA. The intrarenal duplex was performed on admission and after CA, and resistivity index (RI) and pulsatility index were estimated. Results Compared to serum creatinine before CA, its values increased significantly but within the normal range 4 h after CA (0.86±0.23 vs 1.08±0.52 mg/dl, P<0.05), and compared to the estimated creatinine clearance rate before CA, its values reduced significantly but within the normal range 4 h after CA (110.33±34.19 vs 92.98±25.41 ml/min, P<0.001). Compared to L-FABP before CA, it values increased significantly 4 h after CA (5.19±1.95 vs 39.28±13.06 μg/ml, P<0.001), and compared to RI before CA, the index increased significantly 4 h after CA (0.62±0.1 vs 0.67±0.12, P<0.001). L-FABP could predict RA, with area under the curve at 0.55 (sensitivity 41%, specificity 76%) and cutoff value at 39.1 μg/ml. RI could also predict RA, with area under the curve at 0.65 (sensitivity 69%, specificity 48%) and cutoff value at 0.56. Conclusion This study highlighted the importance of L-FABP and RI in early prediction of RA 4 h after contrast media injection and earlier than either serum creatinine or its clearance rate. Although L-FABP is more specific, but RI showed more sensitivity to RA.


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