Abstract: SA-PO082

Early Detection of Urine Neutrophil Gelatinase-Associated Lipocalin for 90-Day Mortality Prediction in Cirrhotic Patients with AKI

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Wang, Zemin, Ningbo NO.2 Hospital, Ningbo City, China
  • Luo, Qun, Ningbo NO.2 Hospital, Ningbo City, China
  • Zhou, Fangfang, Ningbo NO.2 Hospital, Ningbo City, China
Background

Our study was to investigate the prediction role of early detection of urine neutrophil gelatinase-associated lipocalin (uNGAL) after risk factors for 90-day mortality in cirrhotic patients with acute kidney injury (AKI).

Methods

We conducted a prospective nested case-control study of 90 cirrhotic patients with risk factors (bacterial infections, bleeding from oesophageal varices, large volume paracentesis (>3L/d), increased dosage of diuretics, and receiving contrast medium). Urine samples were collected at the time of risk factors occurred and 1d,2d and 3d after the risk factors. Among these patients, 11 patients diagnosed as AKI(KDIGO AKI criteria, 2012). 9 patients were selected as controls, matched by age and gender. uNGAL was measured by ELISA. All the patients were followed up for 90 days.

Results

There were no significant differences in terms of baseline characteristics between AKI and control group. In the AKI group, the levels of uNGAL of 1-day, 2-day and 3-day after risk factors were significantly higher than those at the time of risk factors happened(P=0.013, P=0.009, P=0.012). Totally 6 patients (30%) died during the 90-day follow-up period. The rate of mortality was much higher in patients with AKI compared with control group patients (P < 0.05). uNGAL level of 1d and 2d after risk factors was significantly higher in deceased patients compared with those in surviving patients (189.43(108.88,368.27) vs. 66.03(20.55,115.42), P=0.049; 148.31(70.06,326.68) vs.45.42(20.43,97.33), P=0.039). The serum Na, albumin, total bilirubin, levels of uNGAL, and scores of Child-Pugh and MELD were signficantly associated with prognosis. Multivariate Cox regression analysis showed that uNGAL value of 2d after risk factors and MELD score independently predict 90-d mortality. ROC curve analysis showed that the plot of the uNGAL of 1-day and 2-day after risk factors could predict the risk of 90-day mortality in cirrhotic patients (AUC=0.792 (95%CI: 0.526-1.000), P=0.049; AUC=0.806 (95%CI: 0.584-1.000), P=0.039, respectively).

Conclusion

Early detection (1-2 days) of uNGAL after risk factors could predict 90-day mortality in cirrhotic patients with AKI, independent of other commonly used risk factors.

Funding

  • Government Support - Non-U.S.