Predictive value of serum neutrophil gelatinase-associated lipocalin for acute kidney injury in high-risk elderly patients
10.3760/cma.j.issn.0254-9026.2023.03.014
- VernacularTitle:血清中性粒细胞明胶酶相关脂质运载蛋白在老年急性肾损伤高风险患者的预测价值
- Author:
Lulu GUO
1
;
Fei GAO
;
Tao ZHANG
;
Weihong ZHAO
Author Information
1. 南京医科大学第一附属医院老年肾科，南京 210029
- Keywords:
Neutrophil gelatinase-associated lipocalin;
Acute kidney injury;
Chronic kidney disease
- From:
Chinese Journal of Geriatrics
2023;42(3):316-321
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the predictive value of neutrophil gelatinase-associated lipocalin(NGAL)in high-risk elderly patients with acute kidney injury(AKI).Methods:A retrospective study was conducted to collect 183 patients over 65 years old in the Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University from January 2018 to October 2019.The patients were combined with at least one risk factor.The diagnostic effect of NGAL for AKI prediction in high-risk patients was evaluated.According to the initial serum creatinine(SCr)and basic glomerular filtration rate(eGFR), the patients were divided into chronic kidney disease(CKD)group and non-CKD group.The optimal diagnostic threshold for A-on-C is determined by determining the area under the subject curve(AuROC). Univariate and independent predictors multivariate regression analysis was used to assess the risk of AKI.Results:The serum NGAL(NGAL)level in AKI group was higher than that in non-AKI group[702.5 μg/L(499.2, 813.2) vs.233.9 μg/L(147.2, 315.7), Z=8.002, P<0.001]. In CKD patients, serum NGAL in AKI group was higher than that in non-AKI group[1033 μg/L(845.5, 1447) vs.288.2 μg/L(221.4, 423.3), Z=4.867, P<0.001]. In all patients, model 3 with four variables showed better AKI prediction ability than model 0, 1 and 2( R2=0.743, P<0.001). In the CKD group, the AuROC of serum NGAL for AKI prediction was larger than that of CYS-C group, whereas in the non-CKD group, the AuROC of serum NGAL for AKI prediction was smaller than that of CYS-C group. Conclusions:Serum NGAL may serve as a useful biomarker for AKI prediction in AKI high-risk elderly patients.Especially in patients with CKD, Serum NGAL has a better predictive value for AKI than traditional indicators.
