Prediction Of Urinary Liver-type Fatty Acid Binding Protein And Urinary Interleukin-18 In The Prognosis Of Patients With Acute Kidney Injury

Objective:To assess the values of urinary biomarkers,Interleukin-18(IL-18)and Liver-type Fatty Acid Binding Protein(L-FABP),combining Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)were used to predict the Prognosis of Patients with Acute Kidney Injury(AKI)who required Renal Replacement Therapy(RRT).Methods:A total of 48 hospitalized patients were enrolled at the time of nephrologists consultation.The clinical message of the enrolled patients was recorded and the urine samples were collected.Enzyme-linked immune sorbent assay(ELISA)was carried out to detect the concentration of urinary biomarkers including IL-18 and L-FABP.Patients were followed-up to evaluate the prognosis within 90 days after RRT.Area under curve(AUC)of receiver operating characteristic(ROC)curve and Logistic regression were used to evaluate the value of these biomarkers in prognosis predicting.Results:1.Of the 48 hospitalized AKI patients,20 patients(41.67%)died and 23 patients(47.9%)were dependent on dialysis within 28 days after consultation.28 patients(58.3%)died and 20 patients(41.67%)were dependent on dialysis within 90 days.2.The AUC of urinary IL-18 were 0.719 and 0.844 respectively in predicting 28 and 90 days mortality of the patients and were 0.706 and 0.645 respectively in predicting 28 and 90 days dialysis dependence.3.The AUC of urinary L-FABP were 0.77 and 0.734 respectively in predicting 28 and 90 days mortality of the patients and were 0.719 and 0.674 respectively in predicting 28 and 90 days dialysis dependence.4.When urinary IL-18 and urinary L-FABP were united,the AUC could rise to 0.77 and 0.734 respectively in predicting 28 and 90 days mortality of the patients,while the AUC could rise to 0.741 and 0.684 respectively in predicting 28 and 90 days dialysis dependence.5.When urinary IL-18,urinary L-FABP and APACHEⅡwere united,the AUC could rise to 0.804 and 0.895 respectively in predicting 28 and 90 days mortality of the patients,while the AUC could rise to 0.802 and 0.746 respectively in predicting 28 and 90 days dialysis dependence.Conclusions:Urinary L-FABP and IL-18 alone can predict the prognosis of inpatients with AKI.After combination of the two biomarkers,the predictive ability was increased.And when the APACHE II score was combined,the predictive ability would improved again.