Cystatin C as biomarker of contrast-induced nephropathy in pediatric cardiac angiography.
The purpose of this study is to find the frequency of contrast-induced nephropathy (CIN) and to show the risk factors in the development of CIN and the diagnostic utility of serum cystatin C (CysC) and serum and urine neutrophil gelatinase-associated lipocalin (NGAL) during childhood following cardiac angiography. In this prospective study, we studied 46 children with congenital heart disease. The levels of serum creatinine, serum CysC, and serum NGAL were measured at 4, 24, and 48 h, while levels of urine NGAL and urine creatinine were measured at 4 to 8 and 48 h following cardiac angiography. According to serum creatinine levels, with a cutoff value of 4.1 mL/kg for development of CIN, sensitivity, specificity, area under the receiver-operating characteristic curve, and positive likelihood ratio were calculated as 69%, 70%, 0.67, and 2.29, respectively. The levels of serum CysC and serum creatinine significantly increased at 4, 24, and 48 h after the application of the contrast agent. The results of this study show that according to the definition of CIN, the incidence of CIN is significantly increased in pediatric patients with congenital heart disease. Moreover, the results support that serum CysC levels may allow the detection of CIN after cardiac angiography, like serum creatinine in present study.