The predictive value of combined detection of NGAL,CysC,and NLR in the incidence of CI-AKI after cerebrovascular angiography intervention
Objective To study the predictive value of combined detection of neutrophil gelatinase-associated lipocalin(NGAL),cystatin C(CysC)and neutrophil-to-lymphocyte ratio(NLR)in the incidence of contrast agent acute kidney injury(CI-AKI)after cerebrovascular angiography intervention.Methods 131 patients who underwent cerebral angiography interventional surgery at Beijing Millennium Temple Hospital,Capital Medical University from May 2021 to May 2023 were selected as the study subjects.Following the guideline standards established by the Improving Kidney Outcomes Worldwide Organization(KDIGO),there were 30 cases in the CI-AKI group and 101 cases in the non-CI-AKI group.General information and laboratory indicators of both groups were compared,and statistically significant indicators were then incorporated into a multi-factor binary regression logistic regression equation to analyze the risk factors affecting CI-AKI.Pearson correlation was used to analyze the correlation between NGAL,CysC,NLR,and postoperative Scr.A receiv-er operating characteristic(ROC)curve was drawn to analyze the single and combined predictive value of NGAL,CysC,and NLR for postoperative CI-AKI.Results There were no statistically significant differences in gender,age,type of cerebrovascular disease,body mass index,preoperative Scr,UA,BUN,hemoglo-bin,platelets,and preoperative medications between the two groups(P>0.05).However,there were statisti-cally significant differences in postoperative Scr,Scr increment,eGFR,NGAL,CysC,NLR levels,and con-trast agent doses between the two groups(P<0.05).Logistic regression results showed that Scr,Scr incre-ment,NGAL,CysC,NLR levels and contrast dose increased after surgery were risk factors for CI-AKI(P<0.05).Scr proliferation,NGAL,CysC,NLR levels,and contrast dose were positively correlated with postop-erative Scr levels(P<0.05).The joint prediction sensitivity and specificity of NGAL,CysC,and NLR were 0.902 and 0.843 respectively,with an AUC of 0.755,and a 95%CI of 0.631～0.809(P<0.05).Conclusion Elevated levels of NGAL,CysC,and NLR are risk factors for the development of CI-AKI following cerebral angiography intervention.These three indicators hold significant predictive value for the early diagnosis of CI-AKI and can offer crucial information for subsequent treatment and prognosis.Combined detection of all three markers yields higher efficiency in diagnosing CI-AKI.
NGALCysCNLRCerebral angiography after interventional surgeryContrast-in-duced acute kidney injury
NETL
NSTL
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