SERUM NEUTROPHIL-GELATINASE ASSOCIATED LIPOCALIN AS A PREDICTOR OF POST-CONTRAST ACUTE KIDNEY INJURY IN CHILDREN

Abstract

Background: Post-contrast acute kidney injury (PC-AKI) is a decrease in renal function that follows intravascular administration of contrast media. PC-AKI diagnosis using serum creatinine can be delayed. A new biomarker neutrophil gelatinase associated lipocalin (NGAL) is postulated to be more sensitive for patients prone to PC-AKI. Objective: To assess serum NGAL changes as an early biomarker of PC-AKI in children with congenital heart disease undergoing cardiac catheterization. Methods: This observational study included 30 children with congenital heart disease who underwent cardiac catheterization at the Pediatric Cardiac Catheterization Unit, New Children’s Hospital, Ain Shams University during the period from September 2018 to June 2019. Serum NGAL was measured just before the catheterization, 6 hours and 24 hours after contrast media administration while serum creatinine was measured before and after 24 hours of contrast media administration. Results: The median age was 30 months and 63% were females. Significant rise of serum NGAL was noted within 24 hrs after contrast administration (p < 0.05) while serum creatinine showed a non-significant rise (p>0.05). Serum NGAL was positively correlated with age, weight, height, body surface area and rate of contrast injection (p < 0.01). Higher levels of serum NGAL were found among patients who underwent diagnostic cardiac catheterization (p < 0.05). Conclusions: In children receiving CM for cardiac catheterization, serum NGAL was a sensitive biomarker that could detect PC-AKI as early as 6 hours. Possible risk factors for a raised NGAL include older age and diagnostic catheterization.