Summary:
PURPOSE: To compare the predictive abilities of admission pNGAL, pCysC, uNGAL,
sCr and their combinations for the prediction of AKI development within 7 days
post-ICU admission.
METHODS: This was a prospective observational study of adult ICU patients. AKI
was defined according to RIFLE classification. Blood samples for pNGAL, pCysC,
sCr and urine sample for uNGAL were collected within 1 h, at the latest, of
enrolment. In addition to that, blood samples were obtained 24 and 48 h after
admission for pNGAL, pCysC and sCr.
RESULTS-CONCLUSIONS: Both pNGAL and pCysC levels increased earlier than sCr
levels in the AKI group. When we evaluated the predictive ability for AKI
occurrence only by means of AUC, then none of the three novel biomarkers was
superior to each other or to sCr, while the two combinations were better than
sCr. However, when we assessed the predictive performance with modern indices
of reclassification improvement, namely the category-free NRI and the IDI, the
two combinations were superior not only to sCr, but also to the other three
novel biomarkers. Moreover, pNGAL was superior to the other three.
Keywords:
Acute kidney injury, Renal failure, Biomarkers, NGAL, Cystatin c
