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

• Published in: Critical care (London, England) Vol. 19; no. 1; p. 223
• Main Authors: Dai, Xingui, Zeng, Zhenhua, Fu, Chunlai, Zhang, Sheng’an, Cai, Yeping, Chen, Zhongqing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06.05.2015; BioMed Central
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - diagnosis; Acute Kidney Injury - urine; Acute-Phase Proteins - urine; Adult; Aged; Biomarkers; Biomarkers - blood; Biomarkers - urine; Care and treatment; Cell cycle; Clinical medicine; Comparative analysis; Complications and side effects; Critical care; Critical Illness; Cystatin C - blood; Cystatin C - urine; Data analysis; Female; Gene Expression Regulation; Health aspects; Humans; Infection; Intensive care; Kidney diseases; Lipocalin-2; Lipocalins - blood; Lipocalins - urine; Male; Medical diagnosis; Membrane Glycoproteins - blood; Membrane Glycoproteins - urine; Middle Aged; Mortality; Neutrophils; Plasma; Prospective Studies; Proto-Oncogene Proteins - blood; Proto-Oncogene Proteins - urine; Receptors, Immunologic - blood; Risk factors; Sepsis; Sepsis - blood; Sepsis - diagnosis; Sepsis - urine; Triggering Receptor Expressed on Myeloid Cells-1; Urine
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1466-609X; 1366-609X
• DOI: 10.1186/s13054-015-0941-6

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. 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. 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. 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.