Relationship between basal liver function test levels and contrast-induced nephropathy in patients undergoing coronary angiography

Basal liver function test levels and contrast-induced nephropathy

Abstract

Background:

The purpose of this study was to evaluate the relationship between  initial levels of convantional liver function tests (ALT— Alanine aminotransferase;  AST— Aspartate aminotransferase; GGT— gama glutamil transferase; ALP — alkaline phosphatase) and contrast induced nephropathy (CIN).

Material and methods:

We conducted a retrospective study of 373 subjects with  acute coronary syndrome who underwent coronary angiography (CA). The patients were divided into two groups according to the development of contrast nephropathy or not. CIN is defined as a ≥ 0.5 mg/dL rise in serum creatinine or a 25% increase, assessed within 48-72 hours after administration of contrast medium (CM).

Results:

Overall, CIN developed in 104 patients (group 2 [27.8%]). Both groups were compared with regard to demographic characteristics and liver enzymes (ALT, AST, GGT, ALP). There was a statistically significant relationship between occurrences CIN and Age, AST, ALT, albumin, Hdl (High-density lipoprotein), initial creatinine levels (p=0.025, p<0.001, p<0.001, p=0.001, p<0.033, p=0.001; respectively). In correlation analysis, CIN was positively correlated with ALT and AST   levels (r = 0.161, p = 0.002; r=0.318, p=<0.001; respectively). Multivariate logistic regression analysis demonstrated that   AST  level  was an independent predictor of CIN ( OR 1.006, 95% CI 1.003–1.009, p<0.001). ROC curve analysis was performed, the optimal cut-off value of AST level to predict CIN, AST ≥43 U/L was predictive for CIN with 77% sensitivity and 71% specificity (area under the curve: 0.764, 95% confidence interval [CI]: 0.712-0.817, p<0.001).

 Conclusions:

According to study;  high  AST-ALT levels may predict CIN in patients who undergoing coronary angiography.