肝硬化患者急性肾损伤的尿液生物标志物
Urinary biomarkers of acute kidney injury in patients with liver cirrhosis.
作者信息
Ahmed Qasem Anass, El Sayed Farag Salama, Emad Hamed, Mohamed Emara, Ahmed Bihery, Heba Pasha
出版信息
Med Arch. 2014;68(2):132-6. doi: 10.5455/medarh.2014.68.132-136.
BACKGROUND AND AIM
Acute kidney injury is a common complication in cirrhotic patients. Serum creatinine is a poor biomarker for detection of renal impairment in cirrhotic patients. The aim of this study was to evaluate Urinary Neutrophils Gelatinase-Associated Lipocalin (NGAL) and Urinary interleukin-18 (IL-18) as early biomarkers of acute kidney injury in cirrhotic patients.
PATIENTS AND METHODS
160 cirrhotic patients was enrolled in this study divided into 3 main groups according to presence or absence of ascites and renal impairment.
RESULTS
Significant elevation of both Urinary NGAL and Urinary IL-18 in cirrhotic patients with renal impairment especially in patients with Acute tubular necrosis (ATN) was observed. AUROC was (0.909) with (sensitivity 95.5%, specificity 76.1) for Urinary NGAL and AUROC was (0.975), with (sensitivity 95.5%, specificity 91.3%) for Urinary IL-18.
CONCLUSION
Both Urinary NGAL and Urinary IL-18 can act as urinary biomarkers of acute kidney injury in cirrhotic patient.
背景与目的
急性肾损伤是肝硬化患者常见的并发症。血清肌酐在检测肝硬化患者肾功能损害方面是一种较差的生物标志物。本研究的目的是评估尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和尿白细胞介素-18（IL-18）作为肝硬化患者急性肾损伤的早期生物标志物。
患者与方法
本研究纳入了160例肝硬化患者，根据是否存在腹水和肾功能损害分为3个主要组。
结果
观察到肾功能损害的肝硬化患者，尤其是急性肾小管坏死（ATN）患者的尿NGAL和尿IL-18均显著升高。尿NGAL的曲线下面积（AUROC）为（0.909），敏感性为95.5%，特异性为76.1%；尿IL-18的AUROC为（0.975），敏感性为95.5%，特异性为91.3%。
结论
尿NGAL和尿IL-18均可作为肝硬化患者急性肾损伤的尿生物标志物。
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