Predictive value of novel biomarkers for acute kidney injury in critically ill patients at Assiut University Hospitals

Abstract

Introduction Acute kidney injury (AKI) is a clinical problem in critically ill patients, which is associated with adverse outcomes. There is a persistent need to find reliable biomarkers for the early diagnosis and prediction of AKI. Many genes are upregulated in the damaged kidneys, with the subsequent protein products appearing in the urine. Urinary liver-type fatty acid-binding protein (uL-FABP) and urinary kidney injury molecule-1 (uKIM-1) are among the promising upregulated biomarkers. Aim To assess the ability of uL-FABP in comparison with kidney injury molecule-1 for early prediction of AKI in adult critically ill patients. Patients and methods A cohort study was conducted enrolling 100 critically ill patients admitted to medical critical care units (CCUs) who had risk factors for developing AKI. Acute Physiology and Chronic Health Evaluation II score was calculated on admission. Serum creatinine was measured on admission and thereafter daily till the seventh day of CCU stay. Urine samples for uL-FABP and uKIM-1 assay were collected at the time of CCU admission, on day 3, and on day 5. Results Among critically ill patients, 60% had AKI diagnosed mostly on the second (53.3%) and third (40%) day of CCU admission. There was a significant difference in Acute Physiology and Chronic Health Evaluation II score (P Conclusion UKIM-1 was a sensitive and specific biomarker (superior to uL-FABP) for the prediction of AKI in critically ill patients.