Abstract：
BACKGROUND: Acute kidney injury (AKI) is one of the most severe complications of sepsis. This study was conducted to analyze the role of urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecular-1 (uKIM-1), and urinary angiotensinogen (uAGT) in the early diagnosis and mortality prediction of septic AKI.
METHODS: The prospective study enrolled 80 sepsis patients in the ICU and 100 healthy individuals and divided patients into an AKI group and a non-AKI group. uNGAL, uKIM-1, uAGT, serum creatinine/procalcitonin/C-reaction protein, and other indicators were determined, and clinical prediction scores were recorded. The sensitivity and specificity of uNGAL, uKIM-1, and uAGT in diagnosis and mortality prediction were analyzed by the receiver operator characteristic (ROC) curve and the area under the curve (AUC).
RESULTS: uNGAL, uKIM-1, and uAGT levels were higher in sepsis patients than healthy controls, higher in AKI patients than non-AKI patients, and higher in AKI-2 and AKI-3 patients than AKI-1 patients. At 0 h after admission, the combined efficacy of three indicators in septic AKI diagnosis (ROC-AUC: 0.770; sensitivity: 82.5%; specificity: 70.0%) was better than a single indicator. At 24 h, uNGAL, uKIM-1, and uAGT levels were higher in sepsis non-survivals than survivals and higher in septic AKI non-survivals than septic AKI survivals. The combined efficacy of three indicators in the prediction of sepsis/septic AKI mortality (ROC-AUC: 0.828/0.847; sensitivity: 71.4%/100.0%; specificity: 82.7%/66.7%) was better than a single indicator.
CONCLUSIONS: uNGAL, uKIM-1, and uAGT levels were increased in septic AKI, and their combination helped the early diagnosis and mortality prediction.
METHODS: The prospective study enrolled 80 sepsis patients in the ICU and 100 healthy individuals and divided patients into an AKI group and a non-AKI group. uNGAL, uKIM-1, uAGT, serum creatinine/procalcitonin/C-reaction protein, and other indicators were determined, and clinical prediction scores were recorded. The sensitivity and specificity of uNGAL, uKIM-1, and uAGT in diagnosis and mortality prediction were analyzed by the receiver operator characteristic (ROC) curve and the area under the curve (AUC).
RESULTS: uNGAL, uKIM-1, and uAGT levels were higher in sepsis patients than healthy controls, higher in AKI patients than non-AKI patients, and higher in AKI-2 and AKI-3 patients than AKI-1 patients. At 0 h after admission, the combined efficacy of three indicators in septic AKI diagnosis (ROC-AUC: 0.770; sensitivity: 82.5%; specificity: 70.0%) was better than a single indicator. At 24 h, uNGAL, uKIM-1, and uAGT levels were higher in sepsis non-survivals than survivals and higher in septic AKI non-survivals than septic AKI survivals. The combined efficacy of three indicators in the prediction of sepsis/septic AKI mortality (ROC-AUC: 0.828/0.847; sensitivity: 71.4%/100.0%; specificity: 82.7%/66.7%) was better than a single indicator.
CONCLUSIONS: uNGAL, uKIM-1, and uAGT levels were increased in septic AKI, and their combination helped the early diagnosis and mortality prediction.
摘要：
背景：急性肾损伤（AKI）是脓毒症最严重的并发症之一。本研究旨在分析尿中性粒细胞明胶酶相关脂质运载蛋白（uNGAL）的作用。尿肾损伤分子-1（uKIM-1），尿血管紧张素原(uAGT)在脓毒性AKI早期诊断和死亡率预测中的应用.
方法：前瞻性研究纳入了80名ICU脓毒症患者和100名健康个体，并将患者分为AKI组和非AKI组。uNGAL,uKIM-1,uAGT,血清肌酐/降钙素原/C反应蛋白，并确定了其他指标，并记录临床预测评分。uNGAL的敏感性和特异性,通过受试者操作特征（ROC）曲线和曲线下面积（AUC）分析uKIM-1和uAGT在诊断和死亡率预测中的作用。
结果：uNGAL，脓毒症患者的uKIM-1和uAGT水平高于健康对照组，AKI患者高于非AKI患者，AKI-2和AKI-3患者高于AKI-1患者。入院后0小时，3项指标在感染性AKI诊断中的联合疗效(ROC-AUC:0.770;敏感性:82.5%;特异性:70.0%)优于单一指标.在24小时，uNGAL,在脓毒症非存活者中uKIM-1和uAGT水平高于存活者,在脓毒症非存活者中uKIM-1和uAGT水平高于脓毒症AKI存活者。3项指标联合预测脓毒症/脓毒症AKI死亡率(ROC-AUC:0.828/0.847;敏感性:71.4%/100.0%;特异性:82.7%/66.7%)优于单一指标。
结论：uNGAL，uKIM-1和uAGT水平在化脓性AKI中升高，它们的组合有助于早期诊断和死亡率预测。
方法：前瞻性研究纳入了80名ICU脓毒症患者和100名健康个体，并将患者分为AKI组和非AKI组。uNGAL,uKIM-1,uAGT,血清肌酐/降钙素原/C反应蛋白，并确定了其他指标，并记录临床预测评分。uNGAL的敏感性和特异性,通过受试者操作特征（ROC）曲线和曲线下面积（AUC）分析uKIM-1和uAGT在诊断和死亡率预测中的作用。
结果：uNGAL，脓毒症患者的uKIM-1和uAGT水平高于健康对照组，AKI患者高于非AKI患者，AKI-2和AKI-3患者高于AKI-1患者。入院后0小时，3项指标在感染性AKI诊断中的联合疗效(ROC-AUC:0.770;敏感性:82.5%;特异性:70.0%)优于单一指标.在24小时，uNGAL,在脓毒症非存活者中uKIM-1和uAGT水平高于存活者,在脓毒症非存活者中uKIM-1和uAGT水平高于脓毒症AKI存活者。3项指标联合预测脓毒症/脓毒症AKI死亡率(ROC-AUC:0.828/0.847;敏感性:71.4%/100.0%;特异性:82.7%/66.7%)优于单一指标。
结论：uNGAL，uKIM-1和uAGT水平在化脓性AKI中升高，它们的组合有助于早期诊断和死亡率预测。
