Serum Alpha1-Microglobulin(α1M) As An Early Predictor Of Contrast Induced Nephropathy

Recent improvements in radiodiagnostic procedures and in cardiovascular percutaneous interventions, together with increased life expectancy, have resulted in the subjection of an increasing number of patients to contrast medium-enhanced examinations or cardiac and angiographic procedure requiring iodinated contrast medium injection. Contrast medium-induced nephropathy is currently defined either as an acute decrease in renal function after intravascular administration of an iodinated contrast medium without evidence of other causes or as an absolute increase in serum creatinine values ≥0.3 mg/dl or a 25% relative increase from baseline values within 48 to 72 hours after injection of a contrast media. Contrast medium-induced damage is the third highest cause of hospital-acquired acute renal failure, and in half of these cases, it occurs after invasive cardiac procedures. Acute renal injury is typically diagnosed by measuring serum creatinine. Unfortunately, creatinine is an unreliable indicator during acute changes in kidney function. the aim of this study was to evaluate serum α1M as early sensitive biomarker of acute kidney injury in patients with normal serum creatinine receiving IV (high-osmolar) contrast media for computerized tomography.