title: Diagnostic value of neutrophil gelatinase-associated lipocalin, cystatin C, and soluble triggering receptor expressed on myeloid cells-1 in critically ill patients with sepsis-associated acute kidney injury.
abstract: BACKGROUND
  Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) are novel diagnostic biomarkers of acute kidney injury (AKI). We aimed to determine the diagnostic properties of these biomarkers for detecting AKI in critically ill patients with sepsis.
  
  
  METHODS
  We divided 112 patients with sepsis into non-AKI sepsis (n = 57) and AKI sepsis (n = 55) groups. Plasma and urine specimens were collected on admission and every 24 hours until 72 hours and tested for NGAL, Cys-C, and TREM-1 concentrations. Their levels were compared on admission, at diagnosis, and 24 hours before diagnosis.
  
  
  RESULTS
  Both plasma and urine NGAL, Cys-C, and sTREM-1 were significantly associated with AKI development in patients with sepsis, even after adjustment for confounders by using generalized estimating equations. Compared with the non-AKI sepsis group, the sepsis AKI group exhibited markedly higher levels of these biomarkers at diagnosis and 24 hours before AKI diagnosis (P < 0.01). The diagnostic and predictive values of plasma and urine NGAL were good, and those of plasma and urine Cys-C and sTREM-1 were fair.
  
  
  CONCLUSIONS
  Plasma and urine NGAL, Cys-C, and sTREM-1 can be used as diagnostic and predictive biomarkers for AKI in critically ill patients with sepsis.
authors.affiliation: Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, China. dyce@2008.sina.com.|Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. dyce@2008.sina.com.
authors.forename: Xingui
authors.initials: X
authors.lastname: Dai
authors.affiliation: Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, China. zhenhuazeng.2008@163.com.|Guangdong Key Laboratory of Shock and Microcirculation Research, Department of Pathophysiology, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China. zhenhuazeng.2008@163.com.
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Zeng
authors.affiliation: Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. 345897890@qq.com.
authors.forename: Chunlai
authors.initials: C
authors.lastname: Fu
authors.affiliation: Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. 13975777000@163.com.
authors.forename: Sheng'an
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China. dycelost@163.com.
authors.forename: Yeping
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, China. zhongqingchen2008@163.com.
authors.forename: Zhongqing
authors.initials: Z
authors.lastname: Chen
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D000209:Acute-Phase Proteins / Q000652:urine; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016638:Critical Illness; D055316:Cystatin C / Q000097:blood / Q000652:urine; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood / Q000652:urine; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood / Q000652:urine; D008875:Middle Aged; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood / Q000652:urine; D011971:Receptors, Immunologic / Q000097:blood; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1