title: Urinary retinol-binding protein as a risk factor of poor prognosis in acute-on-chronic renal injury.
abstract: BACKGROUND
  Acute-on-chronic renal injury was commonly seen in clinical practice. Reversibility of acute-on-chronic renal injury had not yet been carefully explored. This study tested whether urinary biomarkers could be used as a noninvasive prognostic marker in patients with acute-on-chronic renal injury.
  
  
  METHODS
  108 adult patients with pre-existing chronic kidney disease presenting with acute-on-chronic renal injury were included. Urinary retinol-binding protein (uRBP), N-Acetyl-b-D-Glucosaminidase (uNAG) and albumin (uALB) was quantified.
  
  
  RESULTS
  Reversibility of renal function was achieved in 43 patients of the 108 included patients. The levels of urinary retinol-binding protein, N-Acetyl-b-D-Glucosaminidase and albumin for non-recovery acute-on-chronic renal injury patients were much higher than recovery patients. The fourth quartiles of urinary retinol-binding protein were significantly associated with at least 1.055-fold odds of non-recovery and the urinary retinol-binding protein was an independent risk factor for outcome of acute-on-chronic renal injury patients by multivariate logistic regression analysis. Quartiles of both urinary N-Acetyl-b-D-Glucosaminidase and albumin had a graded relationship with the risk for un-recovery AKI. However, after a multivariate logistic analysis, the urinary N-Acetyl-b-D-Glucosaminidase and albumin was not associated with reversibility of acute-on-chronic renal injury.
  
  
  CONCLUSIONS
  In patients with acute-on-chronic renal injury, urinary retinol-binding protein was associated with the reversibility of kidney function. Quantification of urinary retinol-binding protein may be developed as a non-invasive tool for predicting outcome of acute-on-chronic renal injury patients.
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Chunlin
authors.initials: C
authors.lastname: Wang
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Xinghua
authors.initials: X
authors.lastname: Shao
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Xiajing
authors.initials: X
authors.lastname: Che
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Minfang
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Tian
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
authors.affiliation: Molecular Cell Lab for Kidney Disease, Department of Nephrology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China. shanmou_renji@126.com.
authors.forename: Shan
authors.initials: S
authors.lastname: Mou
mesh_terms: D000118:Acetylglucosaminidase; D058186:Acute Kidney Injury / Q000175:diagnosis / Q000503:physiopathology / Q000652:urine*; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000503:physiopathology / Q000652:urine; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D016009:Chi-Square Distribution; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D020127:Recovery of Function; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000652:urine*; D012177:Retinol-Binding Proteins / Q000652:urine*; D012307:Risk Factors; D016482:Urinalysis
chemical_list: D015415:Biomarkers; D012177:Retinol-Binding Proteins; D000118:Acetylglucosaminidase
keywords: Acute-on-chronic renal injury; Prognosis; uALB; uNAG; uRBP