Prediction of acute kidney injury using a combined model of inflammatory vascular endothelium biomarkers and ultrasound indices.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common complication of sepsis, with the burden of long hospital admission. Early prediction of AKI is the most effective strategy for intervention and improvement of the outcomes. OBJECTIVE: In our study, we aimed to investigate the predictive performance of the combined model using ultrasound indices (grayscale and Doppler indieces), endothelium injury (E-selectin, VCAM-1, ICAM1, Angiopoietin 2, syndecan-1, and eNOS) as well as inflammatory biomarkers (TNF-a, and IL-1ß) to identify AKI. METHODS: Sixty albino rats were divided into control and lipopolysaccharide (LPS) groups. Renal ultrasound, biochemical and immunohistological variables were recorded 6 hrs, 24 hrs, and 48 hrs after AKI. RESULTS: Endothelium injury and inflammatory markers were found to be significantly increased early after AKI, and correlated significantly with kidney size reduction and renal resistance indices elevation. CONCLUSIONS: Using area under the curve (AUC), the combined model was analyzed based on ultrasound and biochemical variables and provided the highest predictive value for renal injury.