Combined evaluation of plasma B-type natriuretic peptide and urinary liver-type fatty acid-binding protein/creatinine ratio is related to worsening renal function in patients undergoing elective percutaneous coronary intervention

Clin Exp Nephrol. 2021 Dec;25(12):1319-1328. doi: 10.1007/s10157-021-02113-9. Epub 2021 Jul 13.


Background: There are few reports on the significance for the combined evaluation of blood humoral factors and urinary biomarkers in terms of worsening renal function (WRF) after coronary angiography (CAG)/percutaneous coronary arterial intervention (PCI).

Method and results: Urinary liver type-fatty acid-binding protein (L-FABP), neutrophil gelatinase associated lipocalin (NGAL), and adrenomedullin (AM) were measured less than 24 h before and 3 h, 6 h, 1 day, and 2 days after CAG/PCI. WRF was defined as a > 20% decrease in the estimated GFR. WRF occurred in seven of 100 patients and the increase in L-FABP/creatinine (Cr) at 1 day after CAG/PCI was significantly higher in the WRF group than in the non-WRF group. Plasma B-type natriuretic peptide (BNP) before CAG/PCI and L-FABP/Cr at 1 day after CAG/PCI were independent predictors for WRF. The areas under the receiver-operating characteristic curves were as follows: 0.760 for BNP before CAG/PCI, 0.731 for L-FABP/Cr at 1 day after CAG/PCI, and 0.892 for BNP and L-FABP/Cr. Urinary AM levels after PCI/CAG were negatively correlated only to serum potassium levels. Gene expressions of AM and AM-receptor were detectable in renal tubule epithelial cells. AM increased intracellular second messenger levels in a dose-dependent manner.

Conclusions: Our results suggest that combined evaluation of plasma BNP and urinary L-FABP/Cr is useful as a predictor of renal dysfunction in CAG/PCI patients.

Keywords: Adrenomedullin; B-type natriuretic peptide; Liver type-fatty acid-binding protein; Percutaneous coronary arterial intervention; Worsening renal function.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Biomarkers / urine
  • Cells, Cultured
  • Coronary Angiography / adverse effects
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / therapy*
  • Creatinine / urine
  • Fatty Acid-Binding Proteins / urine*
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney / metabolism
  • Kidney / physiopathology*
  • Kidney Diseases / blood
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / physiopathology
  • Kidney Diseases / urine
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Percutaneous Coronary Intervention / adverse effects*
  • Predictive Value of Tests
  • Prospective Studies
  • Time Factors
  • Treatment Outcome


  • Biomarkers
  • FABP1 protein, human
  • Fatty Acid-Binding Proteins
  • Natriuretic Peptide, Brain
  • Creatinine