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Crit Care. 2015 May 6;19:223. doi: 10.1186/s13054-015-0941-6.

Diagnostic value of neutrophil gelatinase-associated lipocalin, cystatin C, and soluble triggering receptor expressed on myeloid cells-1 in critically ill patients with sepsis-associated acute kidney injury.

Author information

1
Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, China. dyce@2008.sina.com.
2
Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. dyce@2008.sina.com.
3
Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, China. zhenhuazeng.2008@163.com.
4
Guangdong Key Laboratory of Shock and Microcirculation Research, Department of Pathophysiology, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China. zhenhuazeng.2008@163.com.
5
Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. 345897890@qq.com.
6
Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. 13975777000@163.com.
7
Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. dycelost@163.com.
8
Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, China. zhongqingchen2008@163.com.

Abstract

INTRODUCTION:

Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) are novel diagnostic biomarkers of acute kidney injury (AKI). We aimed to determine the diagnostic properties of these biomarkers for detecting AKI in critically ill patients with sepsis.

METHODS:

We divided 112 patients with sepsis into non-AKI sepsis (n = 57) and AKI sepsis (n = 55) groups. Plasma and urine specimens were collected on admission and every 24 hours until 72 hours and tested for NGAL, Cys-C, and TREM-1 concentrations. Their levels were compared on admission, at diagnosis, and 24 hours before diagnosis.

RESULTS:

Both plasma and urine NGAL, Cys-C, and sTREM-1 were significantly associated with AKI development in patients with sepsis, even after adjustment for confounders by using generalized estimating equations. Compared with the non-AKI sepsis group, the sepsis AKI group exhibited markedly higher levels of these biomarkers at diagnosis and 24 hours before AKI diagnosis (P < 0.01). The diagnostic and predictive values of plasma and urine NGAL were good, and those of plasma and urine Cys-C and sTREM-1 were fair.

CONCLUSION:

Plasma and urine NGAL, Cys-C, and sTREM-1 can be used as diagnostic and predictive biomarkers for AKI in critically ill patients with sepsis.

PMID:
25944130
PMCID:
PMC4449565
DOI:
10.1186/s13054-015-0941-6
[Indexed for MEDLINE]
Free PMC Article

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