• Isidro Torregrosa, Carmina Montoliu, Amparo Urios, Nisrin Elmlili, María Jesús Puchades, Miguel Angel Solís, Rafael Sanjuán, Maria Luisa Blasco, Carmen Ramos, Patricia Tomás, José Ribes, Arturo Carratalá, Isabel Juan, and Alfonso Miguel.
• Servicio de Nefrología, Hospital Clínico Universitario de Valencia, Valencia. isist67@gmail.com
• Nefrologia. 2012 Jan 1;32(1):44-52.

BackgroundAcute kidney injury (AKI) is a common complication in cardiac surgery and coronary angiography, which worsens patients' prognosis. The diagnosis is based on the increase in serum creatinine, which is delayed. It is necessary to identify and validate new biomarkers that allow for early and effective interventions.AimsTo assess the sensitivity and specificity of neutrophil gelatinase-associated lipocalin in urine (uNGAL), interleukin-18 (IL-18) in urine and cystatin C in serum for the early detection of AKI in patients with acute coronary syndrome or heart failure, and who underwent cardiac surgery or catheterization.MethodsThe study included 135 patients admitted to the intensive care unit for acute coronary syndrome or heart failure due to coronary or valvular pathology and who underwent coronary angiography or cardiac bypass surgery or valvular replacement. The biomarkers were determined 12 hours after surgery and serum creatinine was monitored during the next six days for the diagnosis of AKI.ResultsThe area under the ROC curve (AUC) for NGAL was 0.983, and for cystatin C and IL-18 the AUCs were 0.869 and 0.727, respectively. At a cut-off of 31.9 ng/ml for uNGAL the sensitivity was 100% and the specificity was 91%.ConclusionsuNGAL is an early marker of AKI in patients with acute coronary syndrome or heart failure and undergoing cardiac surgery and coronary angiography, with a higher predictive value than cystatin C or IL-18.

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