The early diagnostic value of urinary Sema3A for ICU adult patients with acute kidney injury

Abstract

To research the early diagnosis value of Semaphorin3A as a biaomarker on acute kidney injury(AKI) in adult intensive care unit (ICU), and explore the relationship between Sema3A and sepsis. The objects of the study are patients who were enrolled from July 2013 to December 2013 in XiangYa Hospital ICU. After admission and study enrollment, clinical data were recorded, and every 12 h serum, urinary samples were collected for Sema3A and neutrophil gelatinase associated lipocalin (NGAL) detected by enzyme linked immunosorbent assay (ELISA). According to the development of AKI, patients were divided into AKI group and non-AKI group. According to whether the AKI induced by sepsis, patients were divided into AKI-sepsis group, AKI-non-sepsis group, non-AKI-sepsis-group, non-AKI-and-non-sepsis group. The samples were selected in AKI group when AKI was diagnosed and 24 h before, the time when AKI diagnosed was counted as T (0) h, the other times were counted as T (-12) h, T (-24) h. In non-AKI group, the samples of the first three time points after admission were selected, and counted as T (0) h, T (-12) h, T (-24) h, respectively. Date was collected for statistical analysis. Compared with non-AKI group, AKI urinary Sema3A, urinary NGAL is higher, and the difference was statistically significant. In group AKI urinary Sema3A, urinary NGAL concentration change over time and there is an increasing trend, where the T (-24) h and T (0) h, T (-12) h and T (0) h respective comparison, the difference was statistically significant. Correlation Analysis: T (-24) h urinary Sema3A and urinary NGAL were positively correlated with serum creatinine, APACHE II. The AUC of urinary Sema3A with T (-12) h had the largest area of 0.885 (95% CI 0.774-0.997, P < 0.05); the AUC of urinary NGAL with T (-24) h had the largest area of 0.878 (95% CI 0.788-0.993, P < 0.05).There was no significant difference between sepsis group and non-sepsis group Sema3A, but there is significant difference between the two groups NGAL. There was no significant difference between S-AKI group and non-S-AKI group urinary Sema3A, but urinary NGAL were significantly different between the two groups. Compared with survival group, urinary Sema3A of death group was higher, and the difference was statistically significant. Urinary Sema3A can help early diagnose of adult AKI. Compared to urinary NGAL, the concentration of urinary Sema3A was not affected by sepsis, and will be more useful for prediction.