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Kidney Week

Abstract: PO0069

Efficacy Evaluation of Neutrophil Gelatinase-Associated Lipocalin and Cystatin C in Urine as Biomarkers in Early Diagnosis of AKI in Preterm

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Author

  • Li, Dong, Dalian Municipal women and children's medical center, Dalian, Liaoning, China
Background

To investigate the value of neutrophil gelatinase-associated lipocalin(NGAL) and cystatin C in urine in the early diagnosis of acute kidney injury in preterm and the efficacy of these two biomarkers in urine.

Methods

A prospective study was conducted on 98 preterm admitted to the NICU, including 55 males and 43 females. According to the diagnostic criteria for neonatal AKI published by the Acute Kidney Injury Network and the Kidney Disease Improving Global Outcomes (KDIGO), the serum creatinine is 1.5 times of the basic level or the urine volume is less than 1.5 mL/ (kg*h) ×24 h, 10 cases of AKI and 88 cases of non-AKI were confirmed on the first day of inclusion, 3 cases of AKI and 95 cases of non- AKI were confirmed on the seventh day of inclusion. Urine samples were collected on the day1, day7 of inclusion and the day of urine volume significant decrease (urine volume < 1.5ml/k*h), urine NGAL (uNGAL) and urine cyst-C values were measured by ELISA, meanwhile serum creatinine were measured. The study was approved by the ethical community board and written consent was obtained from the kids' parents.

Results

Among 98 cases, 10 cases were separated in AKI group and 88 in non-AKI group on the admission day, uNGAL and urine cyst-C in the AKI group were significantly higher than those in the non-AKI group (P < 0.05). On day 7, 3 cases were diagnosed AKI and 95 cases in non-AKI group. uNGAL and urine cyst-C in the AKI group were significantly higher comparing with those in the non-AKI group (P < 0.05). Receiver operating characteristic curves (ROC) for the diagnosis of AKI on day 1 and day 7 were drawn, the area under the curve(AUC) of urine cyst-C on day1 and day7 was 0.922 vs. 0.849, the sensitivity was 0.900 on day1(when set the critical value for AKI as 25.19ng/ml), and the sensitivity on day7 was 1(When the critical value was set 23.16ng/ml), and the specificity of urine cyst-C on day1 vs. day7 was 0.795 and 0.737 separately. The area under the curve(AUC) of uNGAL for AKI diagnosis was 0.860(day1) and 0.867(day7). When the critical value for AKI diagnosis was 100.12 g/L, the sensitivity for uNGAL was 1, and the specificity was 0.695. The positive value for uNGAL on day1 and day7 were 90% and 100% separately.

Conclusion

NGAL and cyst-C in urine can be used as biological indicators for the diagnosis of AKI in premature infants.

Funding

  • Government Support - Non-U.S.