Valuable Markers for Contrast-Induced Nephropathy in Patients Undergoing Cardiac Catheterization
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概要
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Background Contrast-induced nephropathy (CIN) frequently complicates cardiac catheterization, so the objectives of present study were to investigate the usefulness of cystatin C before catheterization and establish a cut-off level for CIN, and to examine the changes in cystatin C and several other markers in patients with and without CIN. Methods and Results Prospective study of consecutive 87 patients who underwent elective catheterization: moderate renal disease defined as glomerular filtration rate 30-59ml・min^<-1>・1.73mm^<-2>; cystatin C and creatinine (Cr), urinary liver-type fatty acid-binding protein (L-FABP), α1, β2 microglobulins, N-acetyl-β-D-glucosaminidase, and microalbumin were measured immediately before, and 1, 2, and 3 days after catheterization. CIN occurred in 18 patients and receiver-operating characteristic analysis showed a higher area-under-the-curve for cystatin C compared with serum Cr (0.933 vs 0.832 p=0.012). At a cut-off level of >1.2mg/L, cystatin C before catheterization exhibited 94.7% (95% confidence interval: 0.851-1.015) sensitivity and 84.8% specificity for detecting CIN. Cystatin C levels were higher in CIN patients than in those without CIN, even before catheterization (cystatin C: 1.08±0.22 vs 1.36±0.28mg/L, p=0.007). Urinary L-FABP was increased on days 1 and 2 in patients with moderate renal disease. Conclusion Cystatin C was useful for predicting the occurrence of CIN. Urinary L-FABP was the only marker of transient renotubular damage.
- 2008-08-20
著者
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SATO Naoki
Intensive and Cardiac Care Unit, Nippon Medical School
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MIZUNO Kyoichi
Department of Internal Medicine, Nippon Medical School
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Katoh Takao
1st Department Of Internal Medicine Nippon Medical School
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Tanaka K
The First Department Of Internal Medicine Nippon Medical School
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Matsuda Koichi
Department Of Internal Medicine Tokyo Metropolitan Komagome Hospital
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IWASAKI Yu-ki
The Cardiovascular Institute
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Yamamoto Takeshi
Intensive and Cardiac Care Unit, Nippon Medical School
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Tanaka Keiji
Intensive and Cardiac Care Unit, Nippon Medical School
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Satoh Naoki
Tokyo CCU Network Scientific Committee
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Iwasaki Yu-Ki
Intensive and Cardiac Care Unit, Department of Internal Medicine, Nippon Medical School Hospital
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Kato Koji
Intensive and Cardiac Care Unit, Department of Internal Medicine, Nippon Medical School Hospital
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Sato Naoki
Department Of Internal Medicine (divisions Of Cardiology Hepatology Geriatric And Integrated Medicin
-
Sato Naoki
武蔵野赤十字病院
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Iwasaki Yuki
The Cardiovascular Institute
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Kumazaki Tatsuo
Department Of Radiology And Center For Advanced Medical Technology Nippon Medical School
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Sato Naoki
日本医科大学 内科学
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Kijima T
Department Of Cardiology Tokyo Women's Medical University
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Tanaka Keiji
Department Of Cardiology Tokyo Women's Medical University
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Kawara Tokuhiro
心臓血管研究所
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Tanimoto Kyomi
Department Of Disease Control And Homeostasis Graduate School Of Medical Science Kanazawa University
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Sato Naoki
Intensive And Cardiac Care Unit Nippon Medical School
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高野 加寿恵
東京女子医科大学内分泌センター内科
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Mizuno Kyoichi
Department Of Internal Medicine (divisions Of Cardiology Hepatology Geriatrics And Integrated Medici
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Kato Takeshi
The First Department Of Internal Medicine Nippon Medical School
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Iwasaki Yu-ki
First Department Of Internal Medicine Nippon Medical School
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Kato Katsuhito
Intensive And Cardiac Care Unit Nippon Medical School
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Kato Koji
First Department Of Internal Medicine Nippon Medical School
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Mizuno Kyoichi
Department Of Internal Medicine Division Of Cardiology Nippon Medical School
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Serizawa Naoki
Department Of Cardiology Heart Institute Of Japan Tokyo Women's Medical University
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Tanimoto Kyoumi
Division Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical University
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Tanaka Keiji
日本医科大学 集中治療室
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Mizuno Kyoichi
Department Of 1st Internal Medicine Nippon Medical School
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Tanaka Keiji
Intensive And Cardiac Care Unit Nippon Medical School
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Katagiri Takashi
The Third Department Of Internal Medicine Showa University School Of Medicine
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Tanizaki Kohei
Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical University
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Serizawa Naoki
Tokyo Ccu Network Scientific Committee
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Satoh Naoki
Coronary Care Unit Nippon Medical School
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Katoh Takao
Division Of Cardiology Department Of Medicine Nippon Medical School
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Tokuyama Kenichi
Departments Of Intensive Care Unit Chiba Hokusoh Hospital Nippon Medical School
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Katoh Koji
Intensive And Coronary Care Unit Nippon Medical School
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Kosugi Munenori
Department Of Cardiology Tama-nagayama Hospital Nippon Medical School
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Mizuno Kyoichi
The First Department Of Internal Medicine Nippon Medical School
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Katoh Koji
Coronary Care Unit Nippon Medical School
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Toba Ken
Division Of Hematology Niigata University Medical And Dental Hospital
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Iwasaki Yuuki
The First Department Of Internal Medicine Nippon Medical School
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Takahashi Yasuhiro
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Mizuno Kyoichi
Division Of Cardiology Hepatology Geriatrics And Integrated Medicine Department Of Internal Medicine
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Serizawa Naoki
Department Of Cardiology Tokyo Women's Medical University
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Matsugami Keiko
Laboratory Of Molecular Medicine Human Genome Center Institute Of Medical Science The University Of
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Kato Takao
Department Of Disease Control And Homeostasis Graduate School Of Medical Science Kanazawa University
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Yamamoto Teppei
Division Of Cardiology And Regenerative Medicine Department Of Internal Medicine Nippon Medical School
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