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| Clinical Value of Blood sCD14-ST Combined with Urinary NGAL on Early Diagnosis of Acute Kidney Injury in Patients with Sepsis |
| HE Xiaowen, XU Yuxiang, ZHANG Jiuzhi, et al |
| Xidian Group Hospital of Xi’an, Shaanxi Xi’an 710077, China |
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Abstract Objective: To investigate the effect of serum soluble cluster of differentiation 14 subtype (sCD14-ST) combined with urinary neutrophil gelatinase-associated lipocalin (NGAL) on the early diagnosis of acute kidney injury (AKI) in patients with sepsis. Methods: 132 patients with sepsis from October 2015 to December 2018 were selected and divided into AKI group (n=41) and non-AKI group (n=91) according to presence or absence of AKI. Then the serum creatinine (Scr), sCD14-ST, and urinary NGAL levels at 0, 4, 8, 12, 24 hours after sepsis were measured and analyzed. Results: ①The hospitalization time and 30-day mortality rate in the AKI group were significantly higher than those in the non-AKI group (P<0.05). ②There was no significant difference in serum Scr levels at 0, 4 and 8 hours in AKI group (P>0.05). The serum Scr level at 12 hours was significantly higher than those at 0, 4, 8 hours and non-AKI group, and the serum Scr levels at 24 hours was significantly higher than those at 0, 4, 8, 12 hours and non-AKI group(P<0.05). There was no significant difference in serum sCD14-ST and urinary NGAL levels at 0, 4 hours in AKI group (P>0.05). The levels of sCD14-ST in blood at 8 hours, 12 hours and 24 hours were significantly higher than those at 0h, 4 hours and non-AKI groups, and the levels of sCD14-ST in blood at 24 hours were significantly higher than those at 8 hours(P<0.05), and the levels of urine NGAL at 12 hours and 24 hours were significantly higher than those in 0, 4 hours and non-AKI groups, and the levels of NGAL in urine at 12 hours and 24 hors were significantly higher than those in 8 hours, and the urine at 24 hours was significantly higher than those in 12 hours (P<0.05). The blood Scr, sCD14-ST and urinary NGAL levels within non-AKI group at the post 0h had no difference with those of any other time points (P>0.05). ③ ROC curve analysis showed that the serum sCD14-ST threshold value was 927.50pg/mL, the sensitivity and specificity were 90.12% and 83.63%, respectively; the urine NGAL threshold value was 85ng/mL, and the sensitivity and specificity were 89.36% and 84.34%, respectively. The sensitivity and specificity of serum sCD14-ST combined with urinary NGAL for early diagnosis of sepsis in patients with sepsis were 91.45% and 86.23%, respectively. Conclusion: Serum sCD14-ST combined with urinary NGAL has a high predictive value for early diagnosis of sepsis in patients with sepsis, which is worthy of clinical application.
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2019, Vol. 25 
