The value of urinary neutrophil gelatinase-associated lipocalin and cystatin C in clinical diagnosis of sepsis with acute kidney injury in preterm infants / 中国医师进修杂志

ABSTRACT

Objective:To investigate the clinical diagnosis value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and Cystatin C (Cys C) of late onset sepsis (LOS) with acute kidney injury(AKI) in preterm infants.Methods:A case-control study was used among preterm infants diagnosed with LOS and admitted to the NICU of Dalian Women and Children′s Medical Group from November 2018 to October 2021, including 24 cases of sepsis AKI group and 40 cases of sepsis non-AKI group. The blood creatinine, urine NGAL, Cys C levels and urine volume were measured at 1 d after birth and 1 d after sepsis. The t-test was used for statistical analysis, and the receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of blood creatinine, urinary NGAL and Cys C in LOS combined with AKI. Results:Blood creatinine, urinary NGAL and Cys C levels were significantly higher in the sepsis AKI group than that in the sepsis non-AKI group (53.667 ± 20.040) μmol/L vs. (35.975 ± 9.048) μmol/L, (1.613 ± 0.405) μg/L vs. (0.839 ± 0.258) μg/L, (39.524 ± 11.619) μg/L vs. (21.778 ± 3.302) μg/L ( P<0.01). Comparison of ROC curves showed that in sepsis AKI group the AUC (0.946 and 0.965, respectively), sensitivity (97.5% and 100.0%, respectively) and specificity (75.0% and 79.2%, respectively) of the urinary NGAL and Cys C levels were higher in than those of creatinine level (AUC 0.771, sensitivity 95.0%, specificity 62.5%), with statistically significant differences ( P<0.05). Conclusions:Urinary NGAL and Cys C are more sensitive than creatinine and can be used as biological indicators for the early diagnosis of sepsis with AKI in preterm infants.