title: Diagnostic performance of urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin for acute kidney injury in an obstructive nephropathy patient.
abstract: OBJECTIVE
  We investigated the diagnostic performance of urinary kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) for acute kidney injury (AKI) in 90 obstructive nephropathy patients.
  
  
  METHODS
  Urine samples were obtained preoperatively and 4, 8, 12, 24, 48 and 72 h postoperatively, and urinary KIM-1 and NGAL contents were measured by enzyme linked immunosorbent assay and corrected against urine creatinine content. The receiver operating characteristic (ROC) curves were used to determine the area under the curve (AUCs) of urinary KIM-1 and NGAL for AKI.
  
  
  RESULTS
  The baseline urinary KIM-1 contents were higher in AKI patients than non-AKI patients (P < 0.01). Urinary NGAL contents were also higher in AKI patients than non-AKI patients (P < 0.001). The area under the curve (AUC) of urinary KIM-1 was 0.900 (P = 0.004) and at a cutoff of 338.26 pg/mg Cr, the sensitivity was 90% and the specificity was 75%. The AUC of urinary NGAL was 0.900 (P = 0.004) and at a cutoff of 261.76 ng/mg Cr, the sensitivity was 90% and the specificity was 87.5%. The combined AUC of urinary KIM-1 and NGAL was 0.938 (P = 0.002) with a sensitivity of 90% and a specificity of 100%. Cox regression analysis revealed that urinary KIM-1content 72 h after operation correlated with the prognosis of AKI patients (P = 0.009). When kidney viability was stratified by urinary KIM-1 content 72 h postoperatively, Kaplan-Meier analysis showed that patients with a urinary content of KIM-1 < 138.20 pg/mg had a higher kidney viability rate than those with a urinary content of KIM-1 > 138.20 pg/mg.
  
  
  CONCLUSIONS
  Urinary KIM-1 and NGAL had a good accuracy for detecting AKI. KIM-1 72 h postoperatively can predict the renal outcome of obstructive nephropathy.
authors.affiliation: Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xue
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Xie
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.forename: Weijia
authors.initials: W
authors.lastname: Xu
authors.forename: Shan
authors.initials: S
authors.lastname: Mou
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000652:urine; D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D018450:Disease Progression; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D053208:Kaplan-Meier Estimate; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D016015:Logistic Models; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012372:ROC Curve; D011991:Receptors, Virus; D012189:Retrospective Studies; D013997:Time Factors; D014517:Ureteral Obstruction / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000652:urine
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus
keywords: acute kidney injury; kidney injury molecule-1; neutrophil gelatinase-associated lipocalin; prognosis; receiver operating characteristic obstructive nephropathy