Combined evaluation of plasma B-type natriuretic peptide and urinary liver-type fatty acid-binding protein/creatinine ratio is related to worsening renal function in patients undergoing elective percutaneous coronary intervention

• Published in: Clinical and experimental nephrology Vol. 25; no. 12; pp. 1319 - 1328
• Main Authors: Yoshihara, Fumiki, Hosoda, Hiroshi, Doi, Takahito, Yoshida, Morikatsu, Kitamura, Kazuo, Yamamoto, Haruko, Asaumi, Yasuhide, Ishibashi-Ueda, Hatsue, Kishida, Masatsugu, Arisato, Tetsuya, Matsuo, Miki, Miyazato, Mikiya, Yasuda, Satoshi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-12-2021; Springer Nature B.V
• Subjects: Adrenomedullin; Aged; Aged, 80 and over; Angiography; Angioplasty; Biomarkers - blood; Biomarkers - urine; Brain natriuretic peptide; Cells, Cultured; Coronary Angiography - adverse effects; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - therapy; Creatinine; Creatinine - urine; Epithelial cells; Fatty acid-binding protein; Fatty Acid-Binding Proteins - urine; Fatty acids; Female; Gelatinase; Glomerular Filtration Rate; Humans; Kidney - metabolism; Kidney - physiopathology; Kidney Diseases - blood; Kidney Diseases - diagnosis; Kidney Diseases - physiopathology; Kidney Diseases - urine; Leukocytes (neutrophilic); Lipocalin; Male; Medicine; Medicine & Public Health; Middle Aged; Natriuretic Peptide, Brain - blood; Nephrology; Original Article; Peptides; Percutaneous Coronary Intervention - adverse effects; Predictive Value of Tests; Prospective Studies; Renal function; Time Factors; Treatment Outcome; Trinucleotide repeats; Urology; Adrenomedullin; B-type natriuretic peptide; Liver type-fatty acid-binding protein; Worsening renal function; Percutaneous coronary arterial intervention
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-021-02113-9

Background
There are few reports on the significance for the combined evaluation of blood humoral factors and urinary biomarkers in terms of worsening renal function (WRF) after coronary angiography (CAG)/percutaneous coronary arterial intervention (PCI).
Method and results
Urinary liver type-fatty acid-binding protein (L-FABP), neutrophil gelatinase associated lipocalin (NGAL), and adrenomedullin (AM) were measured less than 24 h before and 3 h, 6 h, 1 day, and 2 days after CAG/PCI. WRF was defined as a > 20% decrease in the estimated GFR. WRF occurred in seven of 100 patients and the increase in L-FABP/creatinine (Cr) at 1 day after CAG/PCI was significantly higher in the WRF group than in the non-WRF group. Plasma B-type natriuretic peptide (BNP) before CAG/PCI and L-FABP/Cr at 1 day after CAG/PCI were independent predictors for WRF. The areas under the receiver-operating characteristic curves were as follows: 0.760 for BNP before CAG/PCI, 0.731 for L-FABP/Cr at 1 day after CAG/PCI, and 0.892 for BNP and L-FABP/Cr. Urinary AM levels after PCI/CAG were negatively correlated only to serum potassium levels. Gene expressions of AM and AM-receptor were detectable in renal tubule epithelial cells. AM increased intracellular second messenger levels in a dose-dependent manner.
Conclusions
Our results suggest that combined evaluation of plasma BNP and urinary L-FABP/Cr is useful as a predictor of renal dysfunction in CAG/PCI patients.