The Value And Clinical Significance Of ALR In Early Diagnosis Of Acute Kidney Disease

Purpose: Acute kidney injury(AKI)is a serious disease effecting quality of life.So effective diagnosis becomes more and more important.The traditional diagnostic method of acute kidney injury has so many disadvantages that we can’t diagnose acute kidney injury as early as possible.We found that the expression of augmenter of liver regeneration(ALR)increased in kidneys in rats with acute kidney injury,which indicates that ALR may be a biomarker of AKI.We design this experiment to investigate the value of augmenter of liver regeneration in the diagnosis of acute kidney injury(AKI).Method: Sixty-four patients(mean age: 47 ± 8.3;male patients: 34,femal patients: 30)were recruited from October 2014 to October 2015 and assigned to acute kidney injury group(AKI group)or non-acute kidney injury group(non-AKI group)according to KDIGO.Samples were collected from each patient at 0h,6h,12 h,24h,48 h and 72 h after entering the experiment.All the data was evaluated by receiver operator characteristic curve(ROC)analysis and area under curve(AUC)analysis.Results: Forty of the 64 patients developed acute kidney injury(62.5%).Compared with non-AKI group,the hematic ALR level of AKI group was increased quickly after entering this experiment and reached peak at 12 h.The differences of concentration of hematic ALR at 6h、12h、24h、48h、72h have statistical significance between AKI group and non AKI group.The area under the receiver operating characteristic curve(ROC),the sensitivity and specificity for 12 h hematic ALR after entering this experiment are 0.993(95% CI: 0.977,1;P<0.05);0.975 and 0.958 respectively.Compared with non-AKI group,the urine ALR level of AKI group was increased more slowly than hematic ALR after entering this experiment and reached peak at 24 h.The differences of concentration of urine ALR at 6h、12h、24h、48h have statistical significance between AKI group and non AKI group.The area under the receiver operating characteristic curve(ROC),the sensitivity and specificity for 24 h urine ALR after entering this experiment are 0.984(95% CI: 0.96,1;P<0.05);0.975 and 0.917 respectively.Compared with non-AKI group,the serum creatinine level of AKI group was increased much more slowly than hematice ALR and urine ALR after entering this experiment and moderately increased.The differences of concentration of serum creatinine at 12h、24h、48h、72h have statistical significance between AKI group and non AKI group.The area under the receiver operating characteristic curve(ROC),the sensitivity and specificity for 72 h serum creatinine after entering this experiment are 0.878((95% CI: 0.772,0.984;P<0.05),0.95 and 0.792 respectively.Conclusion: Elevated urine and hematic ALR are closely associated with AKI.Urine and hematic ALR increased quickly in the early stage of AKI,which indicates that they are useful as the predictors of patients with AKI.