Value of Soluble Urokinase-Type Plasminogen Activator Receptor in Contrast-Induced Acute Kidney Injury in Percutaneous Coronary Intervention Patients

Abstract

Background: Soluble urokinase-type plasminogen activator receptor (suPAR) is a circulating protein that has been found as a promising biomarker for a variety of kidney injuries. The predictive utility of suPAR in contrast-induced acute kidney damage (CI-AKI) in percutaneous coronary intervention (PCI) is uncertain.Aim: This study aimed to assess prediction CI-AKI using suPAR in patients undergoing PCI. Methods: This case-control study was carried out on 80 subjects undergoing PCI. Subjects were divided into 2 groups 40 patients developed CI-AKI in addition to control group includes 40 subjects with non-CI-AKI. The radial or right femoral artery was punctured using the PCI Seldinger puncture technique. Specific laboratory investigation was evaluation of suPAR in serum using Luminex assay.Results: The suPAR marker was a significant predictor of CI-AKI among PCI patients (AUC=0.982, P<0.001). suPAR cut off point (>2.55 ng/mL) showed sensitivity of 92.5%, specificity of 97.5% for the diagnosis of CI-AKI. Combined creatinine before contrast and suPAR cut off point showed sensitivity of 95%, specificity of 100%In CI-AKI patients, there was a significant positive correlation between suPAR marker levels and each of creatinine level after contrast (r=0.375, P=0.017) and urinary albumin creatinine ratio (r=0.396, P=0.011). Increased levels of suPAR were associated with higher odds (2334.63) of having CI-AKI.Conclusion: Higher suPAR levels were detected in cases in comparison to controls. SuPAR showed accepted performance criteria in CI-AKI prediction. The combined creatinine level before contrast and suPAR improves the sensitivity and specificity. The suPAR is an independent predictor of CI-AKI in primary PCI.