Evaluation of renal function parameters in acute kidney injury patients secondary to liver cirrhosis
10.13602/j.cnki.jcls.2017.09.05
- VernacularTitle:肝硬化患者继发急性肾损伤的实验室评价
- Author:
Bin GE
1
;
Yan LIE
;
Ge XU
;
jiang Duo WU
;
lu Ya QIN
;
fu Jia FENG
Author Information
1. 西南医科大学医学检验系
- Keywords:
liver cirrhosis;
acute kidney injury;
neutrophil gelatinase associated lipocalin;
cystatin C;
creatinine
- From:
Chinese Journal of Clinical Laboratory Science
2017;35(9):657-661
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical application of measurements of neutrophil gelatinase associated lipocalin in serum (sN-GAL) and urine(uNGAL),cystatin C(CysC) and serum creatinine(sCr) in diagnosis of acute kidney injury(AKI) patients secondary to liver cirrhosis (LC).Methods A total of 260 liver cirrhosis patients without AKI (LC group),207 liver cirrhosis patients with AKI (AKI group)and 106 healthy controls(HC group)were included in the study.The levels of sNGAL,uNGAL,serum creatinine(sCr) and cystatin C (CysC) were determined,respectively.The estimated glomerular filtration rate (eGFR) were calculated base on sCr and CysC,named as c-aGFR and CysC-eGFR.The differences and correlation of each observed parameters among the various groups were statistically analyzed,and the effectiveness of these parameters as biomarkers for predicting the development of AKI in these patients with liver cirrhosis were assessed.Results Compared with LC group and healthy control group,the levels of sNGAL,uNGAL,sCr and CysC in AKI group were significantly increased(all P ＜0.01),while the levels of c-aGFR and CysC-eGFR were significantly decreased(all P ＜ 0.01).Along with the progression of AKI stages,the levels of sNGAL,uNGAL,sCr and CysC in the patients were increasing(all P ＜ 0.01),while the levels of c-aGFR and CysC-eGFR were decreasing(all P ＜0.01).Correlation analysis showed that the levels of sNGAL,uNGAL and CysC were positively correlated with sCr(r =0.662,0.672,0.726,all P ＜0.01)and negatively correlated with c-aGFR(r =-0.639,-0.661,-0.732,all P ＜ 0.01).On the contrary,CysC was negatively correlated with sCr (r =-0.711,P ＜ 0.01)and positively correlated with c-aGFR (r =0.736,P ＜ 0.01).ROC curve analysis showed that the area under the curve (AUC) of uNGAL was maximum (0.995) which were significantly higher than that of sNGAL,sCr,c-aGFR,CysC and CysCeGFR(all P ＜ 0.01).The AUC of sNGAL did not present marked difference with that of sCr and CysC (P ＞ 0.05),but-was barely higher than that of c-aGFR and CysC-eGFR (P ＜ 0.05).The diagnostic effectiveness of uNGAL was maximum (0.962),followed by sNGAL(0.920).Conclusion For diagnosis of the development of AKI in the patients with liver cirrhosis,NGAL may be more reliable marker than sCr and CysC,and the detection of uNGAL could be more effective than sNGAL for the diagnosis.
