Evaluation of Dickkopf-3 in acute kidney injury in patients undergoing coronary angiography: A pilot atudy
Abstract
Introduction: Urinary dickkopf-3 (DKK3), which is a kidney tubular stress marker has been suggested recently for preoperative identification of patients at risk of acute kidney injury. We aimed to assess the predictive role of urinary DKK3/creatinine (Cr) ratio in contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI). Methods: This prospective observational study included patients undergoing elective PCI. The association between the ratio of precontrast urinary concentrations of DKK3/Cr and post contrast CIN. The serum Cr, urinary DKK3 and Cr levels of the patients were measured before and after contrast media administration, and the sensitivity of urinary DKK3/Cr ratio in diagnosing CIN in the early stage was assessed by the area under receiver operating characteristic curve. Results: A total of 44 patients (33 males) undergoing PCI were enrolled and mean age of the patients was 61.5 ± 10.0 years. 22.7% of the patients developed CIN, none of them received hemodialysis during hospitalization. The mean urinary DKK3/Cr ratio was 950 ± 491 pg/mg in the CIN patients versus 386 ± 272 pg/mg in the non- CIN patients before contrast media administration (p=0.001). The mean urinary DKK3/Cr ratio was 1266 ± 738 pg/mg in the CIN patients versus 305 ± 192 pg/mg in the non- CIN patients at 12th hour after contrast media infusion (p<0.001). The roc-curve for the urinary DKK3/Cr ratio before contrast administration (AUC=0.835, p=0.001). Conclusions: Pre-contrast urinary DKK3/Cr ratio is a predictor for CIN. Urinary DKK3/Cr ratio may help in the identification of patients who are at risk of CIN.
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