RESUMEN
Objective To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin,sNGAL) and cardiovascular events in patients with chronic kidney disease(CKD).Methods 300 patients with CKD were divided into two groups according to the level of sNGAL:high sNGAL group (n=158) and low sNGAL group (n=142).The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve,and the correlation between sNGAL and cardiovascular risk factors,cardiovascular events in patients with chronic renal disease was analyzed.Influencing factors of cardiovascular events in CKD patients was analyzed.Results There were significant differences in the data about BMI,diabetes proportion,CKD staging,eGFR,hsCRP,24h proteinuria,HDL,iPTH,phosphate and blood calcium between the two groups (P＜0.05).The 3-year cumulative survival rate of high sNGAL group(77.2％) was significantly lower than that of low sNGAL group(96.5％),and the 3-year incidence of cardiovascular events (37.9％) was significantly higher than that of low sNGAL group (9.8％) (P＜ 0.05).AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR(0.636),age (0.504),serum calcium (0.545),HDL(0.594) and LDL (0.508,all P＜0.05).There was a significant correlation between sNGAL and eGFR,HDL,BMI,hs-CRP,iPTH and phosphate (P＜ 0.05).Both univariate and multivariate fact ors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P＜0.05),((HR=1.976 and 1.588,95％ CI=1.443-2.724 and 1.144-2.143,respectively,P=0.O00 and 0.000)).Conclusions The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased.sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease.
RESUMEN
Objectives: To investigate the early diagnostic value of neutrophil gelatinase-associated apolipoprotein (NGAL) on contrast induced nephropathy (CIN) in patients after percutaneous coronary intervention (PCI). Methods: A total of 200 patients received coronary angiography (CAG) and PCI in our hospital from 2016-01 to 2017-02 were enrolled and the research included in 2 groups: CIN group, 23 and Non-NCI group, according to 4:1 ratio, 92 patients without NCI. Serum levels of creatinine, blood and urine levels of NGAL were examined and compared at pre-operation and 4 h, 24 h, 48 h and 72 h after the operation between 2 groups. Results: All patients received CAG and CIN occurred in 23/200 (11.5%) patients. Compared with Non-CIN group, CIN group had more patients with elder age, more smokers and diabetes, P<0.05. Pre-operative blood and urine NGAL were both at normal level and it was similar between 2 groups, P>0.05. In CIN group, urine NGAL was significantly increasing at 4 h after operation and gradually increasing to 72 h after operation; blood NGAL was significantly increasing at 4 h after operation, it began decreasing at 24 h after operation and remained a relatively high level at 72 h after operation; post-operative blood and urine levels of NGAL were different from pre-operative condition at each time points, all P<0.05. In Non-CIN group, post-operative blood and urine levels of NGAL were similar to pre-operative condition, P>0.05. Post-operative blood and urine NGAL were different at the same time point between 2 groups, P<0.01. AUC of ROC for post-operative urine NGAL at 4h, 24h, 48h and 72h were 0.908, 0.926, 0.931 and 0.957 respectively, the sensitivity and specificity for CIN diagnosis were 91.3% and 100% at 4 time points; AUC of ROC for post-operative blood NGAL at 4 h and 24 h were 0.964 and 0.913, the sensitivity and specificity for CIN diagnosis were 87.3% and 100% at both time points. Conclusions: Blood and urine levels of NGAL may reflect renal function changes earlier than serum creatinine in CAG/PCI patients, it had the higher sensitivity and specificity for CIN diagnosis and could be used as the early predictor for CIN occurrence.