Differences in the diagnostic and prognostic values of urine biomarkers for acute kidney injury in patients with or without acute respiratory distress syndrome
10.16571/j.cnki.1008-8199.2016.08.009
- VernacularTitle:尿液中肾损伤标志物对急性呼吸窘迫综合征并发急性肾损伤的诊断预后价值
- Author:
Liang LUO
;
Chengjian YANG
;
Xiaoxian LU
;
Xiaoxia JI
;
Jie BAO
;
Qianqian LI
- Publication Type:Journal Article
- Keywords:
Acute respiratory distress syndrome;
Urine;
Acute kidney injury;
Biomarkers
- From:
Journal of Medical Postgraduates
2016;29(8):827-831
- CountryChina
- Language:Chinese
-
Abstract:
Objective The purpose of study was to investigate the differences in the value of urine acute kidney injury ( AKI) biomarkers in the diagnosis and prognosis of AKI in patients with or without acute respiratory distress syndrome ( ARDS ) . Methods We collected the clinical data about 304 ICU patients, in-cluding 105 ARDS (49 in the lungs and 48 outside the lungs) and 199 non-ARDS cases.Using ELISA, we determined the levels of uN-GAL, uL-FABP, uKIM-1, and uIL-18 in the first 48 hours, compared the clinical data and AKI biomarkers between different groups of patients.We analyzed the differences in the diagnostic value of the AKI biomarkers using the ROC curve and their value in predicting hospital mortality by logistic regression analysis. Results Compared with the patients without AKI, the AKI cases exhibited a signif-icantly increased level of uKIM-1 (1.02 [0.57, 3.01] vs 4.68 [54.74, 270.54], P=0.000) in the ARDS group and that of uL-FABP in the non-ARDS group (102.69 [37.98, 348.09] vs 53.52 [10.86, 141.39], P=0.009).In the ARDS group, the area under the ROC curve (AUC) for the combined efficiency of the four AKI biomarkers was 0.81 (95% CI 0.70-0.92), markedly higher than that of uNGAL (0.57 [95%CI 0.43-0.70]), uL-FABP (0.55 [95%CI 0.39-0.71]), and uIL-18 (0.56 [95%CI 0.40-0.72]) alone (P<0.05), so was the AUC for the combined efficiency of the four biomarkers than that of each biomarker alone in the patients with ARDS in or outside the lungs (P<0.05).The OR value of uKIM-1 for predicting hospital mortality was 1.529 (95%CI 1.148-2.036) in the ARDS group, 1.593 (95%CI 1.070-2.369) in the patients with ARDS in the lungs, and 1.512 (95%CI 1.005-2.274) in those with ARDS outside the lungs. Conclusion There were differences of diagnostic and predictive value of Urine AKI biomarkers have different values in the diagnosis and prognosis of AKI in ARDS and non-ARDS patients and in those with ARDS in or outside the lungs.
