The role of neutrophil gelatinase-associated lipocalin in identifying contrast induced nephropathy development in the emergency department.

OBJECTIVE To evaluate the diagnostic significance of neutrophil gelatinase-associated lipocalin in detecting the development of contrast-induced nephropathy in patients undergoing contrast imaging in an emergency department setting. METHODS The case-control study was conducted at the emergency department of Uludag University, Turkey, between January 1 and July 1, 2012, and comprised patients who underwent a diagnostic thoracic or abdominal Computed Tomography examination with contrast agent. At 2 hours and 72 hours after the scan, control urea, creatinine, and neutrophil gelatinase-associated lipocalin values were recorded. Plasma lipocalin measurement was performed using fluorescence-detected immunoassay method. An increase in serum creatinine of more than 0.5 mg/dl or 25% elevation from the basal level was considered to be a marker for the occurrence of contrast-induced nephropathy. SPSS 13 was used for statistical analysis. RESULTS Of the 80 subjects in the study, 60 (75%) were cases and 20 (25%) were controls. Contrast-induced nephropathy did not develop in any of the patients, and, accordingly, no significant increase of plasma urea, creatinine, or neutrophil gelatinase-associated lipocalin levels was observed. A significant positive relationship was found between urea and creatinine levels at 2 hours (p < 0.009) and at 72 hours (p < 0.001). CONCLUSIONS Diagnostic contrast computed tomography examination in patients with normal renal function did not lead to Contrast-induced nephropathy or increased neutrophil gelatinase-associated lipocalin levels, an accepted early indicator of kidney injury.