title: [Value of acute renal injury associated biomarkers for patients in intensive care unit].
abstract: OBJECTIVE
  To evaluate the early predictive and diagnostic significance of the acute kidney injury (AKI) associated biomarkers for patients in the intensive care unit (ICU).
  
  
  METHODS
  From January to June, 2014, relevant clinical data of participants were collected upon admission to the intensive care unit (ICU) in Affiliated Hospital of Zunyi Medical College. Levels of serum cystatin C (sCys C), neutrophil gelatinase-associated lipocalin (sNGAL), urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecule-1 (uKIM-1), interleukin-18 (uIL-18), and N-acetyl-beta-D-glucosaminidase (uNAG) were detected by enzyme linked immune sorbent assay (ELISA), and compared between AKI and non-AKI patients. Diagnostic significance of these biomarkers was evaluated by a receiver operating characteristic (ROC) curve and the area under the ROC curve.
  
  
  RESULTS
  A total of 176 patients were enrolled in this study. Among them, 71 patients were diagnosed as AKI, in which 57 patients hospitalized with AKI and 14 developed AKI after 24 h hospitalization. The renal replacement therapy ratio was increased with the progress of clinical stage for AKI. AKI mortality rate was 18.8% (46.5% of the total number of deaths). The levels of sCys C, sNGAL, uNGAL, and uIL-18 in AKI patients were increased compared with those in the non-AKI patients (P<0.05). With the progress of AKI, sCys C, and uNGAL levels were also elevated. In 14 patients who suffered from AKI 24 h after hospitalization, the average levels of sCys C, uNGAL, uIL-18, and uKIM-1 were significantly increased (P<0.05). Sensitivity and specificity of the uNGAL, sCys C, and uIL-18 in AKI diagnosis were 97.2%, 76.1%, 54.9% and 93.3 %, 96.2%, 78.1%, respectively. The areas under the ROC curve of uNGAL, sCys C, and uIL-18 were 0.99, 0.90, and 0.69, respectively.
  
  
  CONCLUSIONS
  uNGAL, sCys C and uIL-18 can be used to predict and diagnose AKI, and to evaluate the AKI clinical stage.
authors.affiliation: Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou 563003, China.
authors.forename: Minmin
authors.initials: M
authors.lastname: Gong
authors.affiliation: Department of Nephrology, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou 563003, China.
authors.forename: Yibin
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Health Center, Zunyi Military Subarea, Zunyi Guizhou 563003, China.
authors.forename: Shixian
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D000209:Acute-Phase Proteins / Q000652:urine; D015415:Biomarkers / Q000097:blood* / Q000652:urine*; D016022:Case-Control Studies; D055316:Cystatin C / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007362:Intensive Care Units; D020382:Interleukin-18 / Q000652:urine; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood / Q000652:urine; D008562:Membrane Glycoproteins / Q000652:urine; D011518:Proto-Oncogene Proteins / Q000097:blood / Q000652:urine; D012372:ROC Curve; D011991:Receptors, Virus; D012680:Sensitivity and Specificity
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D000118:Acetylglucosaminidase