The value of plasma NGAL and Cystatin C in the diagnosis of type 1 cardiorenal syndrome

Type of funding sources: None.

The presence of acute kidney injury in the setting of acute heart failure (AHF) is common occurrence and was termed type 1 cardiorenal syndrome (CRS1). Neutrophil gelatinase-associated lipocalin (NGAL) is one of the earliest biomarkers of acute kidney injury due to ischemia or renal toxicity. Cystatin C has a role in the diagnosis renal dysfunction. Does the combination of NGAL and Cystatin C increase diagnostic value of CRS1? This study was aimed to evaluate the diagnostic value of plasma NGAL and Cystatin C in diagnosis of CRS1.

there were 139 patients with AHF in the department of Cardiovascular resuscitation and Interventional cardiology Ho Chi Minh City Vietnam 115 People Hospital from September 2018 to March 2019. This was a prospective cohort study.

the optimal cut-off plasma NGAL to diagnosing CRS1 was 353.23 ng/ml, Area Under Curve (AUC) 0.732 (95% CI 0.65-0.80, p < 0.001), sensitivity 74.47%, specificity 68.48%, positive predictive value 54.7%, negative predictive value 84%. The optimal cut-off Cystatin C to diagnosing CRS1 was 1.81 mg/l, AUC 0.787 (95% CI 0.71-0.852, p < 0.001), sensitivity 75%, specificity 83.5%, positive predictive value 70.6%, negative predictive value 86.4%. Combination of plasma NGAL and Cystatin C in diagnosing CRS1 with AUC 0.787 (95% CI 0.71-0.852, p < 0.001), sensitivity 72.9%, specificity 86.8%, positive predictive value 74.5%, negative predictive value 85.9%.

Combination of plasma NGAL and Cystatin C in the diagnosis of type 1 cardiorenal syndrome with higher specificity than each biomarker.