Background. To evaluate the ratio of acute kidney injury (AKI) to chronic kidney disease (CKD) in sepsis-associated acute kidney injury (SA-AKI) patients of the intensive care unit (ICU) and predictive value of neutrophil gelatinase-associated lipocalin (NGAL) measured at the admission time in the progression of AKI to CKD. Methods. A study of 121 consecutive adult patients admitted to the intensive care unit (ICU) diagnosed as SA-AKI. AKI and CKD were defined based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Glomerular filtration rate (GFR) was calculated by the CKD-EPI formula. Serum and urine NGAL was measured using the BioVendor Human Lipocalin-2/NGAL ELISA with a blood sample taken at hospital admission time. Results. The ratio of AKI to CKD in SA-AKI patients was 22.3%. Mean concentration of serum and urine NGAL in AKI to the CKD group was 790.99 ng/ml and 885.72 ng/ml, higher significantly than those of recovery patients (351.86 ng/ml and 264.68 ng/ml), p<0.001. eGFR, both serum and urine NGAL had a predictive value for AKI to CKD (eGFR: AUC=0.857, Se=74.1%, Spe=92.6%, p<0.001. Serum NGAL: AUC=0.868, Se=77.8%, Spe=91.5%. Urine NGAL: AUC=0.869, Se=77.8%, Spe=92.6%, p<0.001. Conclusion. Serum and urine NGAL, measuring at hospital admission time, were good prognostic biomarkers of AKI to CKD in SA-AKI patients.
Purpose: To evaluate incidence of sepsis-associated acute kidney injury (SA-AKI) in the AKI Intensive Care Unit (ICU) patients and predictive value of Neutrophil Gelatinase-Associated Lipocalin (NGAL) measured at the admission in mortality of SA-AKI and non SA-AKI. Patients and Methods: A study of 101 consecutive adult patients admitted to the Intensive Care Unit (ICU) diagnosed as AKI in which there were 60 patients with SA-AKI. Acute kidney injury was defined based on Acute Kidney Injury Network (AKIN) criteria. Serum NGAL was measured using the BioVendor Human Lipocalin-2/NGAL ELISA with blood sample taken at admission. Results: Incidence of septic acute kidney injury was 59.4%, incidence of death patients reached 20.0%. Mean concentration of serum NGAL in death group was 633.56 ng/ml, higher significantly than that of survival patients (328.84 ng/ml), p<0.005. Serum NGAL in non SA-AKI patients showed a better prognostic value to predict hospital mortality than that in SA-AKI patients (AUC: 0.894 and 0,807 respectively; p < 0.005) Conclusion: In SA-AKI patients, serum NGAL and mortality rate increased along with the stage of AKI. Serum NGAL, measuring at admission time, was a good prognostic biomarker of mortality in both SA-AKI and non SA-AKI patients.
Aims: Carpal tunnel syndrome (CTS) and low serum prealbumin concentration are common in maintenance hemodialysis patients. In this study, we focused on the association between low serum prealbumin levels and carpal tunnel syndrome in maintenance hemodialysis (MHD) patients using low-flux dialysis reuse. Materials and methods: Serum prealbumin levels were assessed to determine the association between low serum prealbumin levels and CTS in 373 prevalent MHD patients (the mean age was 45 years old, hemodialysis duration was 46 months). The patients were divided into 2 groups: the CTS group with 44 patients and the non-CTS group with 329 patients. Results: The prevalence of CTS was 11.8%. Serum prealbumin showed a good prognostic value to predict CTS in MHD patients using low-flux dialysis reuse (the Area Under the Curve ¼ 0.841, p < .001; cutoff value: 26.5 mg/dL with sensitivity ¼ 72.7% and specificity ¼ 79.9%). Conclusions: Serum prealbumin was a good prognostic biomarker of CTS in MHD patients using low-flux dialysis reuse.
Aims: To evaluate the predictive value of urine Neutrophil Gelatinase-Associated Lipocalin (NGAL) measured at the time of admission during the recovery from Acute Kidney Injury (AKI) after 90 days. Materials and Methods: This study includes 101 adult patients admitted to the Intensive Care Unit (ICU) who were diagnosed as AKI (96 patients had been collected 24-hour urine and 5 patients with anuria). Acute kidney injury was diagnosed using the Acute Kidney Injury Network (AKIN) criteria. Urine NGAL was measured at admission using the BioVendor Human Lipocalin-2/NGAL ELISA. Results: The ratio of complete recovery patients after 90 days reached 71.9%. The mean of urine NGAL concentration in the recovery group was 242.04 ng/ml, lower significantly than that of non-recovery patients (371.1 ng/ml), p=0.007. At the cut-off value for 740.03 ng/ml, urine NGAL measured at admission predicted complete recovery with the area under the curve of ROC for urine NGAL = 0.888, p<0.001. Based on the multivariate regression analysis, serum urea, serum creatinine and urine NGAL were independent factors that effected the proportion of recovery in AKI patients (OR=0.856, p=0.023; OR=1.014, p=0.012 and OR=0.993, p<0.001, respectively). Conclusion: Serum urea, serum creatinine and urine NGAL were independent factors that effected the proportion of recovery in AKI patients. Urine NGAL in AKI patients measured at the time of the admission time to ICU can be used as a prognostic biomarker of recovery.
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