Clinical Significance Of The Serum Concentrations Of Insulin-like Growth Factor-1 On Patients With Acute Kidney Injury In Intensive Care Unit

Objective 1.To investigate the nutriture and mortality of patients with acute kidney injury (AKI) in Intensive Care Unit (ICU). 2.To analyze the correlation between serum insulin-like growth factor (IGF-1) and cholesterol in AKI patients.3.To investigate the relationship between the serum concentrations of IGF-1 and AKI patients.Methods A prospective cohort study was designed to investigate the relationship between serum IGF-1 and Subjective Global Assessment(SGA), serum cholesterol and near-term mortality in patients with AKI in ICU from 2008/1/1 to 2010/1/1.All 120 patients were divided into group AKI-1(32 patients) and group AKI-2(88 patients),according to the severity of viscera injury. And 20 healthy were compared as control group.Results 12 patients died in group AKI-1,compared with 60 in group AKI-2,and the total mortality was 60%. Groups were similar regarding age (46.70±16.04 VS 48.59±13.99 VS 47.76±13.55 p >0.05) and bodyweight (53.95±8.12 VS 51.97±7.84 VS 52.44±8.33 p >0.05);The serum IGF-1 were significantly higher in group AKI-1 compared with group AKI-2,and both AKI groups higher compared with control group(466.82±92.93 VS 131.88±50.29 VS 74.02±27.95 p <0.05),as well as cholesterol (4.11±0.89 VS 1.52±0.6 VS 0.79±0.28 p <0.05). The MQSGA were significantly lower in group AKI-1 compared with group AKI-2, and both AKI groups lower compared with control group(2.55±1.23 VS 19.44±4.03 VS 28.63±4.78, p <0.05);The serum IGF-1 were significantly lower in surviving patients of group AKI-2 compared with those of group AKI-1(107.44±21.54 VS 157.89±46.02,p <0.05 ),as well as the nonsurviving patients(88.52±13.75 VS 58.44±12.77,p <0.05); The serum IGF-1 were significantly higher in surviving patients of group AKI-1 compared with those of group AKI-2(157.89±46.02 VS 88.52±13.75, p <0.05). The serum IGF-1 were significantly higher in surviving patients of group AKI-2 compared with nonsurviving patients of group AKI-2(107.44±21.54 VS 58.44±12.77, p <0.05);The serum IGF-1 was correlated with cholesterol( r=0.643,p <0.01) Conclusion Serum IGF-1 is a sensitive index for nutritional assessment in AKI patients in ICU: the lower the IGF-1, the worse the nutriture. And serum IGF-1could reflects the severity of AKI, decreasing corresponding to the degree of severity. Significantly decreased levels of IGF-1 may associated with worse prognosis.