Prospects of contemporary diagnostics of acute kidney injury in patients with acute coronary syndrome


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Abstract

Objective: To assess the clinical significance of urinary excretion of kidney damage markers - albumin, kidney injury molecule-1 (KIM-і) and neutrophil gelatinase-associated lipocalin (Ngal) in patients with acute coronary syndrome (Acs), including complicated by acute renal injury (Ari). Materials and methods: a total of 70 patients with acute coronary syndrome (mean age=64 years, 45 males/25 females) were enrolled in the study. The control group was composed of 1Ο healthy subjects comparable to the study group patients by sex and age. The diagnosis was verified according to clinical guidelines. a complete clinical, laboratory and instrumental examination was performed, including testing of urinary excretion of biomarkers of glomerular (albuminuria) and tubular (KIM-1, ngal) damage. Results: ARI according to the KDIGO definition was found in the majority of the study group patients with ACS (89%). Development of ACI in the study group patients did not depend on age, sex and left ventricular systolic function. It was more strongly correlated with the development of acute myocardial infarction - 47 of 50 (94%) patients, than with unstable angina - 15 of 20 (75%) patients. Both the mean levels of the marker of structural renal damage (albumin, KIM-1 and ngal) in the urine, and the frequency of their increased urinary excretion, were significantly higher in Acs patients with AKI than in patients with preserved renal function. Conclusion: The combination of functional parameters (creatinine dynamics) and markers of structural renal damage (urinary excretion of albumin, KIM-1 and ngal) is necessary to improve timely diagnosis of AKI and predict the prognosis of kidney damage in patients with acute coronary syndrome.

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