Prognostic value of urinary NGAL and KIM-1 combined with APACHEⅡ scoring in patients with sepsis complicated with acute renal injury

Objective To investigate the prognostic value of urinary neutrophil gelatinase-associated lipid carrier protein (NGAL), kidney injury molecule-1 (KIM-1) combined with acute physiology and chronic health Ⅱ (APACHE Ⅱ)scoring in patients with sepsis-induced acute kidney injury (AKI). Methods A total of 108 patients with sepsis complicated with AKI admitted to Hainan Western Central Hospital were divided into the survival group (n=72) and death group (n=36) according to whether they died or not. Urinary NGAL and KIM-1 levels were measured with enzyme-linked immunosorbent assay (ELISA) and APACHE Ⅱ scores were recorded. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of urinary NGAL, KIM-1 and APACHE Ⅱ scores in patients with sepsis complicated with AKI. Results The urinary NGAL(970.2±705.2) vs (612.5±415.4), ng/mL, KIM-1(62.6±12.4) vs (28.8±7.2), ng/L and APACHE Ⅱ score(26.8±8.3) vs (17.9±6.2), score in the death group were significantly higher than those in the survival group (P<0.05). ROC curve analysis showed that the optimal cut-off values of urinary NGAL, KIM-1 and APACHEⅡ scores for predicting AKI mortality were 805.26 ng/mL, 50.35 ng/L and 23.90 points, respectively. Combined use of the three indicators had higharea under the curve (0.937, 95%CI 0.885~0.987), sensitivity (96.3%) and specificity (88.0%) in predicting AKI mortality in sepsis patients were higher. Conclusions Urinary NGAL, KIM-1 and APACHE Ⅱ scores have good predictive value in evaluating the mortality of sepsis patients complicated with AKI, and increase accuracy of prognostic evaluation in patients with sepsis complicated with AKI.