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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, Shanghai 200070, China |
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Abstract 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 of 61.28 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 uL-FABP 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.
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Corresponding Authors:
Tang Qi, E-mail: tangqimed@aliyun.com
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