Urinary Dickkopf-3 and Contrast-Associated Kidney Damage

Administration of iodinated contrast medium (CM) during invasive cardiovascular procedures may be associated with impairment kidney function. Urinary dickkopf-3 (DKK3), a stress-induced renal tubular epithelium–derived glycoprotein, has been identified as biomarker predicting both acute injury (AKI) and persistent dysfunction. DKK3/creatinine ratio (uDKK3/uCr), urine serum neutrophil gelatinase-associated lipocalin (uNGAL, sNGAL) cystatin C (sCyC) were assessed in 458 patients chronic disease scheduled for requiring CM administration universal adoption nephroprotective interventions. Contrast-associated AKI (CA-AKI) was defined creatinine increase ?0.3 mg/dl at 48 h after administration. Persistent dysfunction estimated glomerular filtration rate reduction ?25% 1 month compared baseline. CA-AKI occurred 64 or the (14%), baseline uDKK3/uCr ?491 pg/mg best threshold its prediction. Net reclassification improvement (NRI) significantly increased by adding to Mehran, Gurm, National Cardiovascular Data Registry (NCDR) scores (all p < 0.05), same applied integrated discrimination (IDI) when Gurm NCDR (p 0.001). 57 (12%) ?322 appeared Adding IDI NRI Baseline seems reliable marker improving identification undergoing coronary peripheral risk