The predictive value of serum penKid and IGFBP7 on acute kidney injury in patients with severe burns

Zhao Liang; Li Qinpeng; Jiang Tao; Chen Shaoqing; Li Ming

doi:10.3969/j.issn.1671-6450.2024.03.016

Abstract：Objective To study the levels of serum enkephalinogen A 119-159(penKid)and insulin-like growth factor binding protein 7(IGFBP7)in patients with severe burns and the predictive value of acute kidney injury(AKI).Method Ninety-eight patients with severe burns admitted to the Emergency Department of Peace Hospital affiliated to Changzhi Medical College from April 2019 to April 2022 were selected as the burn group,and they were divided into AKI subgroups according to whether AKI occurred(n=30)and non-AKI subgroups(n=68),and 60 cases of healthy people who had medical checkups in the hospital at the same time were used as the healthy control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum penKid and IGFBP7 in patients within 24 h after injury;multifactorial logistic regression was used to analyze the influencing factors on the occurrence of AKI in patients with severe burns;and the value of the working characteristic curve of subjects to evaluate the prediction of the occurrence of AKI in patients with severe burns by serum penKid,IGFBP7 and the combination of the two was evaluated.Results The serum penKid and IG-FBP7 levels were higher in the burn group than in the control group(t/P=36.873/<0.001,35.841/<0.001).Acute Physiology and Chronic Health Status Evaluation II scores,sequential organ failure scores,blood creatinine,penKid,and IGFBP7 were higher in the AKI subgroup than in the non-AKI subgroup within 24 h of admission(t/P=4.405/<0.001,14.070/<0.001,12.055/<0.001,8.939/<0.001,7.827/<0.001).SerumpenKid and IGFBP7 were sequentially increased with increasing AKI stage in patients with severe burns(F/P=11.922/<0.001,17.381/<0.001).SOFA score,APACHE II score,blood creatinine,serumpenKid,and IGFBP7 were independent risk factors affecting the development of AKI in patients with severe burns[OR(95%Cl)=1.605(1.168-2.205),1.765(1.233-2.526),1.859(1.317-2.625),1.602(1.268-2.022),1.594(1.252-2.028)].The area under the curve(AUC)of serum penKid,IGFBP7 and the combination of the two in predicting the occurrence of AKI in severe burns were 0.804,0.840,0.890,respectively,and the AUC of the two in combination in predicting the occur-rence of AKI in patients with severe burns was higher than that of the single test(Z=4.348,3.847,Pall<0.001).Conclusion Elevated levels of serum penKid and IGFBP7 in patients with severe burns are independent influences on the occurrence of AKI,and the combination of the two has a high predictive value for the occurrence of AKI in patients with severe burns.