Clinical research of urine neutrophil gelatinase-associated lipocalin and interleukin-18 on critically ill patients with acute kidney injury receiving continuous veno-venous hemofiltration
10.3760/cma.j.issn.2095-428X.2015.05.011
- VernacularTitle:持续性血液滤过治疗危重急性肾损伤患儿尿中性粒细胞明胶酶相关脂质运载蛋白和尿白细胞介素-18联合检测的意义
- Author:
Huiying DENG
;
Fazhan ZHONG
;
Yan GAO
;
Ming LI
;
Yanlan WU
;
Huabin YANG
;
Yingjie LI
- Publication Type:Journal Article
- Keywords:
Neutrophil gelatinase-associated lipocalin;
Interleukin-18;
Acute kidney injury;
Critically ill;
Child;
Continuous veno-venous hemofiltration
- From:
Chinese Journal of Applied Clinical Pediatrics
2015;30(5):355-358
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of urine neutrophil gelatinase-associated lipocalin(uNGAL) and urine interleukin-18(uIL-18) on the ill condition and prognosis in critically ill patients with acute kidney injury (AKI) at inception of continuous veno-venous hemofiltration (CVVH).Methods Children came from Department of Nephrology,PICU and health examination center in Guangzhou Women and Children's Medical Center were divided into 4 groups:critically ill patients with AKI receiving CVVH group(group A),critically ill patients with non-AKI receiving CVVH group(group B),critically ill patients with AKI didn't recevie CVVH group(group C),and healthy control group(group D).Serum creatinine(SCr),uNGAL and uIL-18 in all patients were analyzed.Results The uNGAL in group A and group C [(161.56 ± 71.44) μg/L,(153.69 ±51.33) μg/L] increased obviously when compared with group B and group D [(33.50 ± l 0.76) μg/L,(16.37 ± 6.20) μg/L] (all P < 0.05).The uIL-18 in group A and group C[(4.16 ±1.13) μg/L,(3.81 ± 1.05) μg/L] was higher than that in group B and group D [(0.25 ± 0.04) μg/L,(0.19 ± 0.15) μg/L] (all P < 0.05).There was no significance of uNGAL and uIL-18 between group B and group D(all P > 0.05).The peak level of uNGAL[(241.76 ± 53.60) μg/L vs (196.32 ± 39.28) μg/L] and uIL-18[(5.15 ±0.78) μg/L vs (4.30 ±0.89) μg/L] in critically ill patients with AKI was higher in renal recoveries than in renal non-recoveries(P <0.05).The levels of uNGAL and uIL-18 critically ill patients at initiation of CVVH were higher in non-survivors when compared with survivors [(213.50 ± 104.78) μg/L vs (79.91 ± 55.81) μg/L,P < 0.05],[(4.48 ± 2.32) μg/L vs (1.94 ± 1.88) μg/L,P < 0.05].The levels of uNGAL and uIL-18 of critically ill patients with AKI at initiation of CVVH were higher in non-survivors than in survivors [(256.99 ± 49.33) μg/Lvs (127.11 ±38.99) μg/L,P<0.05],[(5.48±0.67) μg/Lvs (3.65 ±0.98) μg/L,P<0.05].The levels of uNGAL and uIL-18 at the first diagnosis time of AKI were higher in non-survivors than in survivors (P < 0.05).Conclusions uNGAL and urine IL-18 at commencement of CVVH predicts short-term prognosis in critically ill patients with AKI.uNGAL and urine IL-18 can be as a prognostic value in the prediction of the need for renal replacement therapy initiation or mortality in critically ill patients with AKI.