title: Evaluation of diagnostic biomarkers for acute kidney injury in major burn patients.
abstract: OBJECTIVE
  Acute kidney injury (AKI) in major burn patients is a common complication with high morbidity and mortality. The mainstream treatment is early diagnosis and rapid termination and prevention of the underlying insult. Therefore, it's essential to identify early biomarkers predicting AKI.
  
  
  METHODS
  A total of 85 patients who were admitted to the burn intensive care unit from June 2012 to July 2013 were included in this prospective cohort study. Ten biomarkers (blood urea nitrogen, serum creatinine, urine creatinine, cystatin C, cystatin C glomerular filtration rate, AST, lacate dehydrogenase [LD], creatine kinase, lactic acid, and myoglobin) were obtained at time of admission and evaluated as diagnostic biomarkers to predicting AKI and early AKI.
  
  
  RESULTS
  Out of 85 patients, 35 patients were dead and overall mortality was 41.2%. The mean age was 49.4 years and mean percentage of total body surface area was 53.2%. Area under the curve (AUC) of receiver operating characteristic curve of biomarkers on predicting AKI were 0.746, 0.718, and 0.717 in LD, lactic acid, and serum creatinine, respectively. AUC of cystatin C predicting AKI was much lower at 0.555. AUC of biomarkers on predicting early AKI were 0.833, 0.816, 0.790, and 0.759 in LD, serum creatinine, AST, and serum myoglobin.
  
  
  CONCLUSIONS
  LD, lactic acid and serum creatinine were acceptable as diagnostic biomarkers of AKI and LD, serum creatinine, AST, and serum myoglobin were reasonable as diagnostic biomarkers of early AKI. However, cystatin C was an unfavorable biomarker in major burn patients.
authors.affiliation: Department of Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Dohern
authors.initials: D
authors.lastname: Kym
authors.affiliation: Department of Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Yong-Suk
authors.initials: YS
authors.lastname: Cho
authors.affiliation: Department of Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Jaechul
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Department of Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Haejun
authors.initials: H
authors.lastname: Yim
authors.affiliation: Department of Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Hyeong-Tae
authors.initials: HT
authors.lastname: Yang
keywords: Acute kidney injury; Biological biomarker; Burns; Cystatin C; Lactate dehydrogenase