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Koroner Anjiyografi Yapılan Hastalarda Kontrast Madde Nefropatisini Saptamada Nötrofil Jelatinaz İlişkili Lipokalinin Yeri

The Role of Neutrophil Gelatinase-Associated Lipocalin (Ngal) in the Determination of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2014.1003.08
Abstract (2. Language): 
OBJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the administration of contrast agent after all other reasons are excluded. We aimed to determine the role of NGAL in the urine for early diagnosis of contrast-induced nephropathy, as the disorder is an important reason of acute renal failure in cases subject to cardiac catheterization clinical practice, and the frequency is increasing. MATERIAL and METHODS: One hundred cases undergoing elective coronary angiography between the dates of January 1st 2011 and March 1st 2011 were included in the study. Urine samples of the patients were taken maximum 4 hours after the coronary angiography to check the urinary NGAL level. RESULTS: The creatinine level had increased 25% in 8 patients at the 48th hour following angiography and this was accepted as CIN. Using a cutoff value of 100 ng/ml, urinary NGAL levels were found to elevated in these 8 patients, consisting of 6 females and 2 males. All them had hypertension (HT) by itself or with other accompanying diseases. CONCLUSION: The CIN diagnosis can be made with the conventional method of measuring the level of creatinine in the blood 48 hours after surgery but using the urinary NGAL method can fasten the diagnosis and treatment and also can shorten hospital stays.
Abstract (Original Language): 
AMAÇ: Kontrast madde nefropatisi; diğer nedenler ekarte edildikten sonra kontrast ajanın uygulanmasını takiben gelişen bir akut böbrek hasarı tablosudur. Çalışmamızda, klinik pratikte sıklığı giderek artan ve kardiyak kateterizasyon yapılan olgularda önemli bir akut böbrek yetmezliği sebebi olan kontrast madde nefropatisinin erken tanısında üriner NGAL(neutrophil gelatinase associated lipocalin)’in yerini saptamayı amaçladık. GEREÇ ve YÖNTEMLER: Çalışmamıza, 1 Ocak 2011 ve 1 Mart 2011 tarihleri arasında elektif koroner anjiyografi uygulanan 100 olgu dahil edildi. Hastaların üriner NGAL seviyeleri için idrar örnekleri koroner anjiyografi yapıldıktan en geç 4 saat içinde alındı. BULGULAR: Koroner anjiyografiyi izleyen 48. saatte 8 hastanın kreatinin seviyeleri en az %25 artmıştı ve kontrast madde nefropatisi(KMN) tanısı konuldu. Bu 8 hastanın tamamında üriner NGAL değerleri kabul edilebilir sınır olan 100 ng/ml üzerindeydi.KMN gelişen hastaların 6’sı kadın ve 2’si erkekti. Tüm hastalarda hipertansiyon veya eşlik eden bir diğer kronik hastalık mevcuttu. SONUÇ: Anjiyografi sonrası KMN tanısı konvansiyonel metodla işlemden 48 saat sonra kreatinin düzeyi bakılarak konulabilmektedir fakat üriner NGAL düzeyi bakılması tanı ve tedaviyi hızlandırabilir ve hastanede kalma süresini kısaltabilir.
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