The predictive value of serum VNN1 and CCN2 detection for acute kidney injury in patients with stage 2-4 chronic kidney disease

Zhou Hongwen; Liu Jianjun; Liu Dongju; Liu Xiaoxia; Tang Yuewu

doi:10.3969/j.issn.1671-6450.2024.03.015

Abstract：Objective To analyze the serum levels of vascular non inflammatory factor 1(VNN1)and cell communi-cation network factor 2(CCN2)in patients with stage 2-4 chronic kidney disease(CKD)and their predictive value for con-current acute kidney injury(AKI).Method One hundred and two patients with stage 2-4 CKD treated in the Department of Nephrology,Liangping Hospital,First Affiliated Hospital of Chongqing Medical University from March 2020 to March 2022 were selected as the CKD group.According to whether AKI was complicated,they were divided into 28 AKI sub-groups and 74 non-AKI subgroups.60 healthy individuals who underwent physical examinations during the same period were selected as the healthy control group.Pearson correlation analysis of the correlation between serum VNN1,CCN2 and renal disease indicators.Multivariate logistic regression analysis was conducted to identify the factors that affect the inci-dence of AKI in stage 2-4 CKD patients;The predictive value of serum VNN1,CCN2,and their combination in predicting AKI in patients with stage 2-4 CKD by analyzing the working characteristic curve of the subjects.Results The serum lev-els of VNN1 and CCN2 in the CKD group were higher than those in the healthy control group(t=34.043,16.383,P<0.001).The levels of serum creatinine,blood uric acid,blood urea nitrogen,24-hour urine protein quantification,and serum VNN1 and CCN2 in the AKI subgroup were higher than those in the non AKI subgroup(t/P=4.842/<0.001,3.578/0.001,5.268/<0.001,3.876/<0.001,20.046/<0.001,10.791/<0.001).The serum VNN1 and CCN2 levels in stage 2-4 CKD patients were sig-nificantly positively correlated with blood creatinine,blood uric acid,blood urea nitrogen,and 24-hour urine protein quantifi-cation(VNN1:r/P=0.627/<0.001,0.624/<0.001,0.521/<0.001,0.705/<0.001;CCN2:r/P=0.646/<0.001,0.610/<0.001,0.536/<0.001,0.689/<0.001).Elevated levels of blood creatinine,blood urea nitrogen,blood uric acid,24-hour urine protein quan-tification,serum VNN1,and CCN2 are independent risk factors for AKI in stage 2-4 CKD patients[OR(95%CI)=1.602(1.268-2.022),1.652(1.263-2.161),1.594(1.252-2.028),1.579(1.196-2.086),1.568(1.131-2.176),1.673(1.124-2.385)].The AUC of serum VNN1,CCN2,and their combined prediction for AKI in stage 2-4 CKD patients were 0.814,0.822,and 0.890,respectively.The combined AUC of the two was greater than that of a single indicator test(Z=4.675,4.513,P<0.001).Con-clusion Elevated serum VNN1 and CCN2 levels are independent risk factors for AKI in patients with stage 2-4 CKD,and their combination has high predictive value for AKI in stage 2-4 CKD.