The study on predictive value of hepcidin in contrast induced acute kidney injury

LI Tian; YAO Qin; CHENG Yuan

doi:10.13820/j.cnki.gdyx.20232080

Abstract：Objective To investigate the predictive value of hepcidin(Hepc)in contrast induced acute kidney injury(CI-AKI).Methods From June 2019 to June 2022,203 patients who underwent radiological examinations u-sing iodine-containing contrast agents at our hospital were included.They were divided into the N-CI-AKI group and the CI-AKI group based on whether they developed CI-AKI after the examination.General clinical data,serum Hepc,creatinine(Scr),neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),and cys-tatin C(CysC)expression levels were compared between the two groups.Multivariate logistic regression analysis was used to obtain independent predictors of CI-AKI after intravenous injection of iodine-containing contrast agents.ROC curves and decision curves for independent predictors were drawn to validate their predictive value.Results In the CI-AKI group,the proportions of patients with chronic kidney disease,diabetes,antibiotic use,and metoprolol use were signifi-cantly higher than those in the N-CI-AKI group(P＜0.05).Hepc,NGAL,CysC,KIM-1 at 24 hours after contrast administration,and NGAL at 48 hours after contrast administration were significantly higher in the CI-AKI group than in the N-CI-AKI group(P＜0.05).Multivariate analysis showed that chronic kidney disease and Hepc after intravenous injection of iodine-containing contrast agents were independent predictors of CI-AKI(P＜0.05).ROC analysis showed that the AUCs for predicting CI-AKI were 0.732(95％CI:0.714-0.834)for chronic kidney disease and 0.825(95％CI:0.763-0.924)for Hepc at 24 hours after contrast administration.The combined prediction had an AUC of 0.936(95％CI:0.887-0.985).Decision curve analysis showed that chronic kidney disease and Hepc at 24 hours after contrast administration had a good net benefit for predicting post-examination CI-AKI.Conclusion The risk of CI-AKI in patients with chronic kidney disease is significantly higher than in those with normal kidney function.Serum Hepc levels at 24 hours after contrast administration can serve as a reliable biomarker for early prediction of CI-AKI.The risk of CI-AKI is higher when Hepc is ≥5.1 ng/mL.