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《Chinese Journal of Critical Care Medicine》 2019-09
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Investigation of urinary liver fatty acid binding protein,serum cystatin C on early diagnosis of acute kidney injury in acute decompensated heart failure patients

Hao Xiao-ping;Wu Bi-bo;Zhang Li-ming;Yu Hua;Tang Qi;Department of Nephrology,Shanghai Jing'an District Zhabei Central Hospital;  
Objective To investigate the value of serum cystatin C(Cys C),urinary liver fatty acid binding protein(uL-FABP) in urine in providing early diagnosis of acute kidney injury(AKI) in patients with acute decompensatory heart failure(ADHF).Methods We examined 57 consecutive patients with ADHF.Serum creatinine(SCr),Cys C and uL-FABP levels were measured at admission and 12,24 and 48 hour after admission.According to AKI diagnostic criteria,all patients were divided into two groups:AKI group and non-AKI group.According to the ROC curve,the diagnostic boundary,sensitivity,specificity,and area under the ROC curve(AUC) were diagnosed by uL-FABP at 12,24 and 48 h.Results AKI developed in 23 patients(40%) in hospitalization.The uL-FABP level of AKI patients was significantly higher than that of non-AKI patients [12 h:(45.78±25.82)μg/(g·Cr)vs.(27.55±12.89)μg/(g·Cr);24 h:(57.04±25.57)μg/(g·Cr) vs.(30.47±12.97) μg/(g·Cr);48 h:(68.69±24.41) μg/(g·Cr) vs.(33.26±10.01) μg/(g·Cr),P 0.01].And it rose in 12 hours.Cys C increased significantly in 24 hours.They both rose earlier than SCr.The ROC curve analysis showed that uL-FABP reached an area of 0.746 at the cut-off point of61.28 μg/(g·Cr) at the time of admission to 12 h,and the sensitivity and specificity reached 80%and 81%,respectively.And it gradually increased with time.The ROC curve analysis showed that uLFABP reached an area of 0.834 at the cut-off point of 80.12 μg/(g·Cr) at the time of admission to 24 h,the sensitivity reached 84%,and the specificity reached 85%.The ROC curve analysis showed that uL-FABP reached an area of 0.914 at the cut-off point of 102.30 μg/(g·Cr) at the time of admission to 48 h,the sensitivity reached 93%,and the specificity reached 88%.The area under the ROC curve of Cys C compared to 24 h is 0.689,which is lower than uL-FABP,and the area under the ROC curve of SCr is 0.503.Conclusion Cys C and uL-FABP can be used as an effective marker for early prediction of AKI incidence in ADHF patients.Acute kidney injury can be detected earlier than traditional indicators SCr.
【Fund】: 上海市靜安區衛生健康委員會醫學科研課題立項(2019MS06)
【CateGory Index】: R541.6;R692
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【Citations】
Chinese Journal Full-text Database 1 Hits
1 YUAN Fang;LIU Hua;WANG Wen-xia;DAI Jin-jie;DAI Li-ying;YANG Xiao-xiao;FANG Wei-yi;Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University;;Study on early diagnosis of acute decompensated heart failure combined with acute renal injury[J];上海交通大學學報(醫學版);2014-12
【Co-citations】
Chinese Journal Full-text Database 2 Hits
1 Hao Xiao-ping;Wu Bi-bo;Zhang Li-ming;Yu Hua;Tang Qi;Department of Nephrology,Shanghai Jing'an District Zhabei Central Hospital;;Investigation of urinary liver fatty acid binding protein,serum cystatin C on early diagnosis of acute kidney injury in acute decompensated heart failure patients[J];中國急救醫學;2019-09
2 Yin Kun;Zhang Wu;Xiang Rui;Deparment of Cardiology,Anyue People's Hospital of Sichuan Province;;Effect of serum soluble ST2 in early diagnosis and short-term prognosis evaluation of acute decompensation of chronic heart failure[J];臨床內科雜志;2019-04
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