Raimann Jochen G, Calice-Silva Viviane, Thijssen Stephan, Nerbass Fabiana Baggio, Vieira Marcos A, Dabel Pascal, Evans Rhys, Callegari John, Carter Mary, Levin Nathan W, Winchester James F, Kotanko Peter, Pecoits-Filho Roberto
Research Division, Renal Research Institute, New York, USA.
Blood Purif. 2016;42(1):64-72. doi: 10.1159/000445041. Epub 2016 Apr 22.
Acute kidney injury (AKI) is a growing global concern and often reversible. Saliva urea nitrogen (SUN) measured by a dipstick may allow rapid diagnosis. We studied longitudinal agreement between SUN and blood urea nitrogen (BUN) and the diagnostic performance of both.
Agreement between SUN and BUN and diagnostic performance to diagnose AKI severity in AKI patients in the United States and Brazil were studied. Bland-Altman analysis and linear mixed effects models were employed to test the agreement between SUN and BUN. Receiver operating characteristics statistics were used to test the diagnostic performance to diagnose AKI severity.
We found an underestimation of BUN by SUN, decreasing with increasing BUN levels in 37 studied patients, consistent on all observation days. The diagnostic performance of SUN (AUC 0.81, 95% CI 0.63-0.98) was comparable to BUN (AUC 0.85, 95% CI 0.71-0.98).
SUN reflects BUN especially in severe AKI. It also allows monitoring treatment responses. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=445041.
急性肾损伤（AKI）是一个日益受到全球关注的问题，且通常是可逆的。用试纸条测量的唾液尿素氮（SUN）可能有助于快速诊断。我们研究了SUN与血尿素氮（BUN）之间的纵向一致性以及两者的诊断性能。
研究了美国和巴西AKI患者中SUN与BUN之间的一致性以及诊断AKI严重程度的诊断性能。采用Bland-Altman分析和线性混合效应模型来检验SUN与BUN之间的一致性。使用受试者工作特征统计量来检验诊断AKI严重程度的诊断性能。
我们发现SUN对BUN存在低估，在37例研究患者中，随着BUN水平升高而降低，在所有观察日都是一致的。SUN的诊断性能（曲线下面积[AUC]为0.81，95%可信区间[CI]为0.63 - 0.98）与BUN（AUC为0.85，95%CI为0.71 - 0.98）相当。
SUN尤其在重度AKI中反映BUN情况。它还可用于监测治疗反应。视频期刊俱乐部“与克劳迪奥·龙科一起品尝卡布奇诺”，网址为http://www.karger.com/?doi=445041。
