Bufkin Kendra B, Silva Jeane
Department of Health Management, Economics and Policy, The Graduate School, Augusta University, Augusta, GA 30912, USA.
J Clin Med. 2024 Dec 12;13(24):7564. doi: 10.3390/jcm13247564.
Acute kidney injury (AKI), a common complication in hospitalized patients, is a clinical syndrome with a sudden and reversible decline in kidney function. Within hospitalization, the average incidence rate is 2% to 5%, and 67% of patients admitted to the Intensive Care Unit (ICU) acquire acute kidney injury. There is a pressing need to identify biomarkers that provide early detection to enhance the diagnosis of acute kidney injury. Neutrophil gelatinase-associated lipocalin (NGAL) has been identified as the most promising biomarker for predicting acute kidney injury due to upregulation as early as 2 h before kidney injury. Urine samples from 52 adult subjects were utilized to evaluate the accuracy of acute kidney injury diagnosis using the XpressCard for human NGAL. Sensitivity and specificity were calculated to analyze the validity of the NGAL XpressCard's ability to accurately distinguish between acute and non-acute kidney injury. The positive and negative predictive values were calculated to determine the prevalence of NGAL and predict the likelihood of diagnosing AKI. Data show that the NGAL XpressCard has a sensitivity and specificity of 59.3% and 95.8% and a positive and negative predictive value of 92.9% and 71.9%, respectively. The human NGAL XpressCard is effective at predicting AKI in hospitalized patients and correlates with high levels of HbA1c, which is associated with diabetes mellitus. It delivers immediate test results, which can enhance patient care.
急性肾损伤(AKI)是住院患者常见的并发症,是一种肾功能突然且可逆性下降的临床综合征。在住院期间,平均发病率为2%至5%,入住重症监护病房(ICU)的患者中有67%会发生急性肾损伤。迫切需要识别能够提供早期检测的生物标志物,以加强急性肾损伤的诊断。中性粒细胞明胶酶相关脂质运载蛋白(NGAL)已被确定为预测急性肾损伤最有前景的生物标志物,因为早在肾损伤前2小时它就会上调。利用52名成年受试者的尿液样本,使用人NGAL快速检测卡评估急性肾损伤诊断的准确性。计算敏感性和特异性,以分析NGAL快速检测卡准确区分急性和非急性肾损伤能力的有效性。计算阳性和阴性预测值,以确定NGAL的患病率并预测诊断AKI的可能性。数据显示,NGAL快速检测卡的敏感性和特异性分别为59.3%和95.8%,阳性和阴性预测值分别为92.9%和71.9%。人NGAL快速检测卡可有效预测住院患者的AKI,且与高水平的糖化血红蛋白(HbA₁c)相关,而糖化血红蛋白与糖尿病有关。它能提供即时检测结果,可改善患者护理。