The Value Of Plasma Soluble Urokinase Plasminogen Activator Receptor In The Early Diagnosis Of Aki In Patients Admitted To Intensive Car E Unit

Objective: To investigate the early diagnostic value of plasma soluble urokinase plasminogen activator receptor(suPAR)in acute kidney injury(AKI)of patients admitted to Intensive care unit(ICU).Methods: Patients who were admitted to ICU of Shengjing Hospital affiliated to China Medical University from August 2020 to December 2020 were divided into two groups according to the criterion of KDIGO guidelines in 2012:AKI group and non-AKI group.The plasma samples were collected within 24 hours after admission and statistics were collected including basical information and routine clinical biochemical tests.The concentration of plasma suPAR(p-suPAR)were determined by enzyme-linked immunosorbent assay(ELISA)and compared between two groups.Finally,p-suPAR were correlated with serum creatinine(s Cr),and the receiver operating characteristic(ROC)curves were plotted to explore the early value of suPAR and s Cr in AKI.Results: 1.Statistics showed that there was no significant difference in gender,age,APACHE II scores and SOFA scores between two groups,p>0.05.2.The value of psuPAR was higher in AKI group than that of non-AKI group,p<0.05,with statistical significance.3.When AKI group was divided into two subgroups : moderate-AKI group(KDIGO staging 1)and severe-AKI group(KDIGO staging 2-3),p-suPAR was positively correlated with s Cr and higher in severe-AKI group than that of moderate-AKI group,p<0.05,with statistical significance.4.When compared separately with non-AKI group,there was no significant difference of p-suPAR between moderate-AKI group and nonAKI group,p>0.05,and p-suPAR was higher in severe-AKI group than that of non-AKI group,p<0.05,with statistical significance.5.When the ROC curves were plotted,the area under the curve(AUC)of p-suPAR was 0.783(95%CI:0.646-0.920),p=0.003,with statistical significance,but the AUC of s Cr was 0.687(95%CI:0.484-0.891),p=0.051,without statistical significance.When p-suPAR and s Cr were combined together,the AUC was 0.802(95%CI:0.657-0.947),p=0.002,with statistical significance.Conclusion: 1.In the presence of AKI,p-suPAR was positively correlated with s Cr and positively correlated with severity of kidney injury.2.P-suPAR may predict severe-AKI of ICU patients earlier than s Cr and improve the diagnostic value of severe-AKI when combined with s Cr,which indicates that suPAR is likely to be used as a new biomarker for early diagnosis of severe-AKI in ICU patients.