RBP In Combination With β₂ Microglobulin For The Early Diagnosis Of AKI

Objective:To investigate the value of combining detection of Retinol-binding protein andβ₂microglobulin in early diagnosis of acute kidney injury.Methods:A total of 130 AKI patients and 128 non-AKI patients admitted to Intensive Care Unit（ICU）of the First Hospital of Shanxi Medical University from June 2020 to June2021 were enrolled.Clinical data was collected,including basic information at admission[gender,age,BMI,APACHEⅡ];Diuretic using rate,sepsis rate,renal replacement therapy（RRT）rate,outcome[The incidence of AKI];The laboratory indexes（bicarbonate,uric acid,cystatin,α₁microglobulin,WBC counts）and serum creatinine,RBP,β₂-MG in the two groups on the first day of ICU admission.The distribution characteristics at different time points are abnormal,so the median（quartile distance）was expressed by M(Q₂₅,Q₇₅),and the Mann-Whitney U test in the nonparametric test was used.Statistical data was compared byχ²test.The Receiver Operating Characteristic（ROC）curve was plotted and the area under the curve（AUC）was calculated for statistical analysis.Results:Compared with non-AKI patients,AKI patients exhibited no significant differences Baseline characteristics.AKI patients had higher APACHEⅡscore,higher diuretic utilization rate,sepsis incidence rate,Renal Replacement Therapy（RRT）rate,longer 28-day RRT time and longer ICU stay.The mortality of AKI patients was significantly higher than that of the non-AKI patients,the length of hospital stay and mortality were positively related to the severity of renal injury.ROC curve showed that the area under RBP curve andβ₂-MG curve were 0.996 and 0.801 respectively on the first day of ICU admission.Combined with the two,the area under curve was0.993（P<0.05）.On the third day of ICU admission,the area under RBP curve andβ₂-MG curve were 0.828 and 0.858,respectively.The area under the combination curve ofβ₂-MG and RBP were 0.869（95%CI:0.797～0.942）,with 0.851 sensitivity and 0.806 specificity.Conclusion:RBP andβ₂-MG possess clinical value for the early diagnosis of AKI.The combination detection of them is better than individual.