Prognostic Role of Neutrophil to Lymphocyte Ratio in Contrast-Induced Nephropathy: A Systematic Review and Meta-analysis

Biomarkers in Contrast-Induced Nephropathy: Advances in Early Detection, Risk Assessment, and Prevention Strategies

Contrast-induced nephropathy (CIN) represents a significant complication associated with the use of iodinated contrast media (ICM), especially in individuals with preexisting renal impairment. The pathophysiology of CIN encompasses oxidative stress, inflammation, endothelial dysfunction, and hemodynamic disturbances, resulting in acute kidney injury (AKI). Early detection is essential for effective management; however, conventional markers like serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) exhibit limitations in sensitivity and timeliness. This review emphasizes the increasing significance of novel biomarkers in enhancing early detection and risk stratification of contrast-induced nephropathy (CIN). Recent advancements in artificial intelligence and computational analytics have improved the predictive capabilities of these biomarkers, enabling personalized risk assessment and precision medicine strategies. Additionally, we discuss mitigation strategies, including hydration protocols, pharmacological interventions, and procedural modifications, aimed at reducing CIN incidence. Incorporating biomarker-driven assessments into clinical decision-making can enhance patient management and outcomes. Future research must prioritize the standardization of biomarker assays, the validation of predictive models across diverse patient populations, and the exploration of novel therapeutic targets. Utilizing advancements in biomarkers and risk mitigation strategies allows clinicians to improve the safety of contrast-enhanced imaging and reduce the likelihood of renal injury.

Prognostic value of neutrophil to lymphocyte ratio and platelet indices in cats with feline panleukopenia

The aim of this study was to ascertain the prognostic significance of the neutrophil to lymphocyte ratio (NLR) and platelet indices during hospital admission in cats with feline panleukopenia (FPV). A prospective observational study was conducted on 24 cats diagnosed with FPV. The results of the study demonstrated a significant decrease in NLR, platelet count (PLT), and platelet concentration (PCT) in the FPV survivor group compared to the control group. Furthermore, these parameters exhibited a notable decline in the FPV non-survivor group when compared to both the control group and the FPV survivor group. In contrast, mean platelet volume (MPV) and platelet distribution width (PDW) were significantly elevated in the FPV non-surviving cats compared to the control group. Moreover, receiver operating characteristic (ROC) curve analysis was employed to identify a prognostic cut-off value for predicting the prognosis of cats with FPV. The positive predictive values (PPVs) for survival were determined to be 90 %, 95 %, 85 %, 85 %, 85 %, and 75 %, respectively, using cut-off values of NLR (≤ 0.29), PLT (≤ 202.5 ×10³/µL), PCT (≤ 0.19 %), MPV (≥ 10.3 fL), and PDW (≥ 34.9 %). Based on the sensitivity, specificity and positive predictive values obtained from the ROC analysis, it was concluded that the NLR, MPV, and PLT are excellent biomarkers for determining prognosis in cats with FPV. Nevertheless, the PLT level is of greater significance, exhibiting a higher AUC.