接受连续性肾脏替代治疗的老年急性肾损伤患者NGAL、KIM-1检测的意义

Significance of serum NGAL and KIM-1 levels in elderly patients with acute kidney injury undergoing continuous renal replacement therapy

目的探讨接受连续性肾脏替代(CRRT)治疗的老年急性肾损伤(AKI)患者血清的中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及肾损伤分子-1(KIM-1)的表达水平及其临床意义。方法分析56例老年AKI患者在接受CRRT治疗前血清NGAL、KIM-1的水平,根据患者转归不同分为存活组(30例)和死亡组(26例),比较两组NGAL、KIM-1水平的差异,并进行受试者工作特征(ROC)曲线分析。结果死亡组血清NGAL、KIM-1水平明显高于存活组,差异有显著统计学意义(P<0.01)。血清NGAL、KIM-1预测接受CRRT治疗的老年AKI患者转归的曲线下面积分别为0.885、0.725。结论血清NGAL、KIM-1可能成为预测老年AKI患者行CRRT治疗时机及转归的生物学标志物。

Objective To investigate the expression and significance of serum NGAL and KIM-1 levels in acute kidney injury （AKI） in elderly patients with continuous renal replacement therapy （CRRT）. Methods In the retrospective study, 56 elderly patients with AKI receiving CRRT were divided into survival group （ rt = 30 ） and death group （ n = 26 ） based on their outcomes. Their serum NGAL and KIM-1 levels were detected and analyzed. At the same time, area under receiver operating characteristic curve （AUROC） was constructed so that the accuracy rate of serum NGAL and KIM-1 levels would be analyzed. Results Serum NGAL and KIM-1 levels were significantly higher in the death group than in the survival group（P 〈0.01 ）. The AUROC of serum NGAL and KIM-1 for predicting the outcomes of elderly patients with AKI receiving CRRT were 0. 885 and 0. 725. Conclusion Serum NGAL and KIM-1 may be good biomarkers for predicting the need of CRRT treatment and the outcomes in elderly patient with AKI receiving CRRT.