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Abstract
Patient assessment by imaging studies using contrast media is currently replacing open procedures, especially in high risk patients. However, the use of such contrast media might result in acute events and injuries after the procedure. Contrast induced nephropathy (CIN) is a complex syndrome of acute renal failure occurring after the administration of iodinated contrast media. With the increasing use of radiocontrast media in diagnostic and interventional procedures over the last 30 years, CIN has become the third leading cause of hospital acquired acute renal failure, at least in the united states and europe. The performance of urinary L- FABP which is a 14- kDa protein expressed in proximal tubular epithelial cells as an early detection marker of AKI has shown promise in various clinical settings. Determination of the renal resistive index (RI) by doppler sonography has also been suggested as a means of diagnosing acute tubular necrosis. The aim of our work is prospective assessment of the clinical biomarker L- FABP and the renal artery duplex for early prediction of acute kidney injury in patients scheduled for coronary angiography. The present study was conducted on 40 patients admitted to the ICU critical care department, Cairo university hospitals scheduled for coronary angiography. Different risk factors for AKI were evaluated, including: patients with diabetes mellitus, hypertensions, dyslipidemia, smoking, ischemic heart disease and the number of diseased coronary arteries. The L- FABP and renal artery duplex was studied for early prediction of acute kidney injury before and after coronary angiography