The Value Of Urinary NGAL And KIM-1 In The Early Diagnosis Of AKI In Critically Ill Patients

Objective: To investigate the early predictive value of urinary neutrophil gelatinase-associated lipocalin(NGAL)and urinary renal injury factor 1(KIM-1)in patients with critically ill acute kidney injury.Methods: Patients who were hospitalized in the ICU of Shengjing Hospital affiliated to China Medical University from May 2017 to December 2017 were divided into two groups: experimental group,AKI group and non-AKI group.Statistics showed that gender,age,etc.matched a total of 47 patients with different etiology,continuous collection of fresh urine samples from 3 days morning fresh 5ml,the use of enzyme-linked immunosorbent assay(ELISA)to detect urinary NGAL,KIM-1 levels,improve the routine clinical biochemical tests,and finally Urinary NGAL and KIM-1 were correlated with serum creatinine(sCr),and the receiver operating characteristic curve(ROC)was plotted to explore the early value of urinary NGAL and KIM-1 in AKI.Results: The value of u NGAL was higher than that of uKIM-1 and sCr in experimental group two days before AKI diagnosis(p <0.05).On the day before AKI diagnosis,uNGAL and uKIM-1 Compared with the control group,the value of sCr increased statistically significant(p <0.05),while there was no significant difference in sCr between the two groups(p> 0.05).According to KDIGO staging,urinary NGAL,KIM-1 and sCr increased gradually with staging(P <0.05),and there was no statistical significance among the three markers in the control group Difference(p> 0.05).There was a positive correlation between urinary KIM-1,NGAL and sCr in the experimental group(p <0.05).In the experimental group,the area under the curve of serum creatinine and urinary KIM-1 were 0.570(95% CI: 0.287-0.854,P = 0.611,respectively,without statistical significance),0.675(95% CI: 0.445-0.906,P = 0.203,no statistical significance).The area under the curve of urine NGAL was 0.895(95% CI: 0.765-1.000,P = 0.004,The cut-off area of serum creatinine was 0.671(95% CI: 0.459-0.884,P = 0.114,no statistical significance),and the area under the curve of urinary KIM-1 was 0.719(95 % CI: 0.536 ~ 0.902,P = 0.043,with statistical significance,the critical value at this time was 165.06).The area under the curve of NGAL was 0.961(95% CI: 0.898-1.000,P = 0.000,The threshold at this time is 176.5850).Conclusion: 1.In the presence of AKI,urinary NGAL and urine KIM-1 were positively correlated with sCr and positively correlated with KDIGO stage of renal injury.2.Urinary NGAL predicts AKI earlier than urinary KIM-1.3.Urinary NGAL and urinary KIM-1 have early diagnostic value for AKI,which can be used as a new biomarker for AKI early diagnosis.