| Objective:To investigate the effects and implication of urinary neutrophil gelatinase-associated lipocalin (NGAL), urinary interleukin-18(IL-18) and urinary kidney injurymolecule-1(KIM-1) in children with acute kidney injury and to guide the diagnosisand the treatment.Methods:80cases of patients were selected in the pediatric nephrology of the first hospitalBethune jilin university from February2011to October2012. During the first week ofenrollment into hospital, including40cases of AKI group,40cases of non-AKI group.40healthy volunteers who matched with AKI group for age and gender were selectedas normal control group. Clinical presentations and urinary samples were collectedwhen the patients were enrollment into our study. The levels of urinary samples wereanalyzed by enzyme-linked immunosorbent assay (ELISA) in urinary samples. Toanalyze the correlation between urinary NGAL, urinary IL-18, urinary KIM-1andserum creatinine, and evaluate the early diagnostic value of urinary NGAL, urinaryIL-18and urinary KIM-1.Result:1.Campared with3days before diagnosis of AKI, urinary NGAL levels rosesignificantly(P＜0.05), urinary IL-18, KIM-1and serum creatinin levels didn’tchange(P＞0.05)2days prior to the diagnosis of AKI in AKI group. Urinary NGAL,IL-18and KIM-1levels rose significantly(P＜0.05), serum creatinine levels didn’tchange(P＞0.05)2days prior to the diagnosis of AKI in AKI group. Urinary NGAL,IL-18, KIM-1and serum creatinine levels didn’t change(all P＞0.05) in non-AKIgroup and healthy group during the study period.2.The urinary NGAL, IL-18and KIM-1levels in the one, two and three groups of AKI were gradually increased and significantly higher than non-AKI group andhealthy group (all P＜0.05).3.Correlation analysis showed that the levels of urinary NGAL, IL-18andKIM-1were positive correlated with the levels of serum creatinine, correlationcoefficients were R=0.608(P＜0.05), R=0.424(P＜0.05), R=0.478(P＜0.05),respectively.4.Receiver operator characteristic curve (ROC) analysis showed that the areaunder the curve (AUC) of urinary NGAL was0.795（P＜0.05), the AUC of urinaryIL-18and urinary KIM-1were0.605(P＞0.05) and0.604(P＞0.05)2days beforediagnosis of AKI;1days before diagnosis of AKI, the AUC of urinary NGAL, IL-18and KIM-1were0.943,0.937and0.913(all P＜0.05), respectively.5.In the diagnosis of AKI, the sensitivity and specificity of urinary NGAL were95%and92.5%, the sensitivity and specificity of urinary IL-18were85%and90%,the sensitivity and specificity of urinary KIM-1were90%and90%.Conclusion:1.Compared with non-AKI group and healthy group, urinary NGAL, IL-18andKIM-1were significantly increased in AKI group, and the levels of urinary NGAL,IL-18and KIM-1were positive correlated with the levels of serum creatinine.2.Urinary NGAL levels rose2days prior to serum creatinine, urinary IL-18andurinary KIM-1rose1days prior to serum creatinine in AKI group.3.Urinary NGAL, IL-18and KIM-1levels were positive correlated with theseverity of kidney injury aggravated.4.Urinary NGAL had higher sensitivity and specificity than urinary IL-18andurinary KIM-1.5.Urinary NGAL, IL-18and KIM-1had clinical significance in early diagnosisof AKI and may be the early predictive biomarkers of AKI in children. |
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