The Predictive Value of the Combination of Serum NGAL,CysC,BUN for Sepsis-Associated Acute Kidney Injury

LI Lin; ZHANG Xianjiang; ZHOU Yun

doi:10.3969/j.issn.2095-3097.2024.06.004

Abstract：Objective To analyze the predictive value of the combination of serum neutrophil gelatinase-associated li-pocalin (NGAL),cystatin C (Cys-C),and blood urea nitrogen (BUN) for sepsis-associated acute kidney injury (SA-AKI) .Methods A study was conducted on298 sepsis patients admitted to our hospital between February2020 and February2023.According to the occurrence of AKI,they were assigned into SA-AKI group (n=82) and non SA-AKI group (n=216),and further assigned into mild SA-AKI group (stage I,n=33) and severe SA-AKI group (stages Ⅱ-Ⅲ,n=49) based on the se-verity of AKI.General information of 298 sepsis patients was collected.Laboratory and serum indicators were tested.Multiva-riate logistic regression was applied to analyze the influencing factors.The predictive value of NGAL,CysC,and BUN for SA-AKI was evaluated using receiver operating characteristic (ROC) curves.Results The sequential organ failure assessment (SOFA) score in the SA-AKI group was higher than that in the non SA-AKI group (P<0.05).The levels of C-reactive pro-tein (CRP),BUN,CysC,and NGAL in the SA-AKI group were higher than those in the non SA-AKI group (P<0.05),and the glomerular filtration rate (eGFR) was lower than that in the non SA-AKI group (P<0.05).The levels of CRP,BUN,CysC,and NGAL in the severe SA-AKI group were higher than those in the mild SA-AKI group (P<0.05),while eGFR was lower than that in the mild SA-AKI group (P<0.05).Multiple logistic regression analysis showed that SOFA score,BUN,CysC,eGFR,and NGAL were all influencing factors of SA-AKI (P<0.05).ROC curve showed that the area under the curve (AUC) of NGAL,CysC,and BUN in predicting SA-AKI was 0.867,0.794,and 0.788,respectively.The combination of the three factors had a higher AUC for predicting SA-AKI (0.945) (Zcombination vs.NGAL=4.604,P<0.001;Zcombination vs.CysC=6.143,P<0.001;Zcombination vs.BUN=6.308,P<0.001).Conclusion Serum NGAL,CysC,and BUN are highly expressed in SA-AKI patients.The combined use of the three for SA-AKI prediction has high value.