| Background:The interaction between organs is defined as endogenous steady-state signaling between vital organs such as the heart,kidneys,and brain.Renal-lung interactions are ubiquitous in certain pathological conditions.Chronic obstructive pulmonary disease(COPD)is a disease characterized by respiratory symptoms and irreversible progressive bronchial obstruction.Because the complication of COPD affects the severity and prognosis of the disease,screening and treatment of comorbidities is the key to controlling COPD.Cardiovascular disease(CVD),osteoporosis,and depression are considered to be typical comorbidities of COPD,but there are few studies on kidney damage.Objective:This study was to evaluate the predictive value of serum cystatin C(sCys-C)and urinary albumin/creatinine ratio(uACR)in acute kidney injury(AKI)in AECOPD patients.Methods:A total of 110 AECOPD patients admitted to our hospital from March 2018 to March 2019 were selected.According to the presence or absence of kidney injury,it was divided into acute kidney injury(AKI)group and no acute kidney injury(NO-AKI)group.Collect general clinical data and laboratory parameters such as sCys-C,serum creatinine(sCr),urine creatinine,albumin levels,body mass index(BMI),estimated glomerular filtration rate(eGFR),white blood cell count(WBC),C-reactive protein(CRP),partial pressure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),blood oxygen saturation(SPO2).The differences between the two groups were compared and analyzed.The correlation between sCys-C,uACR and PO2,PCO2 was analyzed by pearson correlation test.The ROC curve was plotted to assess the value of sCys-C,uACR for predicting renal impairment,and the difference in mutual AUC was assessed using the z-test.Results:The prevalence of AKI in AECOPD patients was28.2%(31/110).The PO2 of the AKI group was significantly lower than that of the no-AKI group[(63.39±4.84)vs(81.69±5.97)mmHg,P<0.001].The SpO2 of the AKI group was also lower than that of the non-AKI group[(88.30±2.12)vs(95.25±2.20)%,P<0.001],The PCO2 of the AKI group was significantly higher than that of the non-AKI group[(48.35±8.57)vs(43.54±5.91)mmHg,P<0.001].The baseline value of eGFR in the AKI group was significantly lower than that in the non-AKI group[(101.20±10.24)vs(108.55±18.16)ml/(min·1.73 m2),P=0.011],The white blood cell count of the AKI group was significantly higher than that of the non-AKI group[(12.40±3.15)vs(5.84±2.31)10~9/L,P<0.001].The CRP level of the AKI group was significantly higher than that of the non-AKI group(49.53±12.30)vs(14.26±3.15)mg/L(P<0.001).In addition,serum Cys C levels in the AKI group were significantly higher than those in the non-AKI group[(1.07±0.08)vs(0.91±0.07)mg/L,P<0.001].The level of uACR in patients with AKI was also significantly higher than non-AKI group[(75.65±9.11)vs(69.01±10.69)mg/L,P<0.001].The hospital stay in the AKI group was significantly higherthanthatinthenon-AKIgroup[(11.21±3.24)vs(6.43±1.52)d,P<0.001].Correlation analysis showed that serum Cys-C and uACR levels were negatively correlated with PO2(r=-0.512,-0.408,P<0.001).Serum Cys-C and uACR levels were positively correlated with PCO2(r=0.698,0.548,P<0.001).The area under the curve(AUC-ROC value)of sCys-C is 0.907,with high specificity(84%)and high sensitivity(83%).The area under the curve of uACR(AUC-ROC value)was0.661,the sensitivity and specificity were(64%,66%),and the AUC-ROC value of sCys-C was significantly higher than that of uACR(P<0.001).Conclusion:The PO2 and SpO2 in the AKI group were significantly lower than those in the no-AKI group.sCys-C and uACR levels are negatively correlated with PO2,and sCys-C and uACR can be used as markers for predicting renal injury in patients with AECOPD,with higher sensitivity and specificity. |
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