Predictive value of urinary triggering receptors expressed on myeloid cells-1 on contrast-induced nephropathy after percutaneous coronary intervention

Objective To evaluate the predictive value of urinary soluble triggering receptors expressed on myeloid cells-1(s TREM-1)on contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI).Methods Patients undergoing PCI were divided into two groups of CIN(n=21)and non-CIN(n=179)according to the occurrence of CIN. Serum creatinine,estimated glomerular filtration rate(e GFR)and urinary s TREM-1 were compared between two groups. The correlation between urinary s TREM-1,serum creatinine and e GFR were analyzed. And early diagnostic value of urinary s TREM-1 in CIN was examined.Results Age(71.48±8.51)year vs(62.92±9.16)yearand diabetic rate(57.15% vs 34.64%)of CIN group were significantly higher than those in non-CIN group(P<0.05). At 4 h、24 h、48 h post-operation,urinary s TREM-1(111.02±14.73)ng/L vs(47.45±10.36)ng/L,(123.81±28.51)ng/L vs(49.29±12.46)ng/L,(134.69±30.37)ng/L vs(45.31±9.48)ng/Lof CIN group was significantly higher than that of non-CIN group (P<0.05). At 4 h、24 h postoperation,serum creatinine and e GFR showed no significant inter-group differences(P>0.05). At 48 h post-operation,serum creatinine(89.05±21.13)vs(63.42±12.42)μmol/Lof CIN group was significantly higher than that of non-CIN group (P<0.05); e GFR(76.28±21.89) m L·min^-1·(1.73m²)^-1vs(112.94±30.46)m L·min^-1·(1.73m²)^-1of CIN group was significantly less than that of non-CIN group(P<0.05). Urinary s TREM-1 was positively correlated with serum creatinine(P<0.05)while urinary s TREM-1 negatively correlated with e GFR(P<0.05). Receiver operator characteristic(ROC)analysis showed that AUC of urinary s TREM-1 was 0.740(95% CI:0.482-0.998)at 4 h post-operation;the sensitivity and specificity for diagnosing CIN were 62.6% and 73.5% at a cut-off level of 89.0 ng/L. AUC of urinary s TREM-1 was 0.931(95% CI:0.868-0.994)at 24 h post-operation and the sensitivity and specificity diagnosing CIN were 86.6% and 73.8% at a cut-off level of 98.0 ng/L.AUC of urinary s TREM-1 was 0.948(95% CI:0.894-1.001)at 48 h post-operation and the sensitivity and specificity for diagnosing CIN were 87.9% and 88.4% at a cut-off level of 108.0 ng/L.Conclusion Urinary s TREM-1 may reflect the early changes of renal function after PCI. It has an excellent value in the early diagnosis of CIN.