Диагностика контраст-индуцированной нефропатии после чрескожного коронарного вмешательства

Изучены возможности ранней диагностики развития контраст-индуцированной нефропатии при выполнении плановой коронарографии и чрескожного коронарного вмешательства у пациентов с хронической ишемической болезнью сердца, а также предикативные способности современных биомаркеров в сравнении с креатинином сыворотки. Исходный уровень β2-микроглобулина сыворотки >1,1 мг/л свидетельствует о высоком риске развития осложнений. При повышении через 24 ч уровней цистатина С (на 25 % от исходного, >1,064 мг/л) или β2-микроглобулина (>1,42 мг/л) в крови острое повреждение почек диагностируется раньше, чем по динамике креатинина, что может быть использовано в рутинной клинической практике. Определение уровня липокалина нейтрофилов в моче повышает точность диагностики, но затруднительно в рутинной практике.

1. European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines on Acute Kidney Injury: Part 1: defnitions, conservative management and contrast-induced nephropathy / D. Fliser [et al.] // Nephrol. Dial. Transplant. – 2012. – Vol. 27, N 12. – P. 4263–4272. https://doi.org/10.1093/ndt/gfs375

2. Haase-Fielitz, A. Instability of NGAL during long-term storage / A. Haase-Fielitz, M. Haase, R. Bellomo // Am. J. Kidney. Dis. – 2009. – Vol. 53, N 3. – P. 564–565. https://doi.org/10.1053/j.ajkd.2009.01.009

3. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker of acute renal injury after cardiac surgery / J. Mishra [et al.] // Lancet. – 2005. – Vol. 365, N 9466. – P. 1231–1238. https://doi.org/10.1016/S0140-6736(05)74811-X

4. The outcome of acute renal failure in the intensive care unit according to RIFLE: model application, sensitivity, and predictability / N. Y. Abosaif [et al.] // Am. J. Kidney. Dis. – 2005. – Vol. 46, N 6. – P. 1038–1048. https://doi.org/10.1053/j.ajkd.2005.08.033

5. GFR Calculator [Electronic resource] // National Kidney Foundation. – 2015. – Mode of access : http://www.kidney.org/professionals/kdoqi/gfr_calculator.cfm. – Date of access : 01.12.2018.

6. A simple risk score for prediction contrast-induсed nephropathy after percutaneous coronary intervention: development and initial validation / R. Mehran [et al.] // J. Amer. Coll. Cardiol. – 2004. – Vol. 44. N 7. – P. 1393–1399. https://doi.org/10.1016/j.jacc.2004.06.068

7. 2018 ESC/EACTS Guidelines on myocardial revascularization / F.-J. Neumann [et al.] // Eur. Heart J. – 2019. – Vol. 40, N 2. – P. 87–165. https://doi.org/10.1093/eurheartj/ehy394

8. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines / F. Stacul [et al.] // Eur. Radiol. – 2011. – Vol. 21, N 12. – P. 2527–2541. https://doi.org/10.1007/s00330-011-2225-0

9. Signifcance of cystatin C for early diagnosis of contrast-induced nephropathy in patients undergoing coronary angiography / M. Wang [et al.] // Med. Sci. Monit. – 2016. – Vol. 22. – P. 2956–2961. https://doi.org/10.12659/msm.897241

10. Cystatin C, but not urinary or serum NGAL, may be associated with contrast induced nephropathy after percutaneous coronary invasive procedures: a single center experience on a limited number of patients / E. Cecchi1 [et al.] // Acta. Medica. Academica. – 2017. – Vol. 46, N 1. – P. 34–43. https://doi.org/10.5644/ama2006-124.184

11. Diagnostic accuracy of serum cystatin C for early recognition of contrast induced nephropathy in Western Indians undergoing catheterization / A. N. Shukla [et al.] // Indian Heart J. – 2017. – Vol. 69, N 3. – P. 311–315. https://doi.org/10.1016/j.ihj.2016.12.010

12. Urinary neutrophil gelatinase-associated lipocalin distinguishes prerenal from in trans renal failure and predict outcomes / E. Singer [et al.] // Kidney. Int. – 2011. – Vol. 80, N 4. – P. 405–414. https://doi.org/10.1038/ki.2011.41

13. Nozue, T. Predictive value of serum cystatin C, β2-microglobulin, and urinary liver-type fatty acid-binding protein on the development of contrast-induced nephropathy / T. Nozue, I. Michishita, I. Mizuguchi // Cardiovasc. Interv. Ther. – 2010. – Vol. 25, N 2. – P. 85–90. https://doi.org/10.1007/s12928-010-0014-3

14. Neutrophil gelatinase-associated lipocalin as an early marker of contrast-induced nephropathy after elective invasive cardiac procedures / N. Kafkas [et al.] // Clin. Cardiol. – 2016. – Vol. 39, N 8. – P. 464–470. https://doi.org/10.1002/clc.22551

15. Biomarker response to contrast administration in diabetic and nondiabetic patients following coronary angiography / V. L. Ashalatha [et al.] // Indian J. Nephrol. – 2017. – Vol. 27, N 1. – P. 20–27. https://doi.org/10.4103/0971-4065.179335