Diagnostic and prognostic performance of serial creatinine, Cystatin c and Neutrophil Gelatinase-associated Lipocalin in for acute kidney injury in critically ill patients with sepsis

Md. Ralib, Azrina and Dzaharudin, Fatimah and Abdul Ghani, Muhamad Rasydan and Mat Nor, Mohd. Basri (2022) Diagnostic and prognostic performance of serial creatinine, Cystatin c and Neutrophil Gelatinase-associated Lipocalin in for acute kidney injury in critically ill patients with sepsis. Malaysian Journal of Anaesthesiology, 1 (2 (Supp)). pp. 73-74. ISSN 2772-9524 E-ISSN 2949-7789

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Abstract

Introduction Acute kidney injury (AKI) is an independent risk factor that contributes to morbidity and mortality in critically ill patients. Plasma Creatinine is the current marker used to diagnose AKI; however, it is delayed biomarker. Newer marker has been shown to have a faster diagnostic utility. Plasma Cystatin (CysC) is a new functional marker, whereas Neutrophil Gelatinase-Associated Lipocalin (NGAL) is injury marker for AKI. We evaluated the diagnostic and prognostic performance of Creatinine, Cystatin C, and NGAL in critically ill patients with sepsis. Methods This is a secondary analysis of a prospective observational study of critically ill pa- tients. Inclusion criteria were patients older than 18 years old with sepsis, defined as clinical infection and increase in SOFA score>2, and plasma procalcitonin>0.5 ng/ml. Plasma creatinine, Cystatin C and NGAL were measured on ICU admission and daily for 3 days. Results A total of 70 patients were recruited, of which 39 (55.7%) had AKI. Plasma Creati- nine had the highest diagnostic performance for AKI throughout the first 3 days of ICU admission with AUC of 0.72 to 0.85. Plasma CysC was diagnostic on Day-1 and Day-2 only, with AUC of 0.76 and 0.77, respectively. Plasma NGAL was diagnostic for AKI throughout the 3 days, with AUC of 0.67 to 0.75. Day-2 Plasma NGAL were in- dependently predictive of 30 days mortality with odds ratio of 9.76 (1.02 to 93.13), p=0.048. Conclusions Plasma Creatinine, CysC and NGAL measured during the first 3 days of ICU admission were diagnostic of AKI. However, only Day-2 Plasma NGAL was independently pre- dictive of 30-day mortality, with optimal cut-off point of 435 ng/ml.

Item Type:	Article (other)
Uncontrolled Keywords:	Creatinine, Cystatin C, NGAL, Acute Kidney Injury, Biomarker
Subjects:	R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Prof Azrina Md Ralib
Date Deposited:	09 Jan 2023 15:34
Last Modified:	09 Jan 2023 15:34
URI:	http://irep.iium.edu.my/id/eprint/102319

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