Title: Evaluation of Serum Biomarkers in High Risk Acute Kidney Injury Patients for their Early Detection and Risk Assessment
Authors: Dr Sangita Biswas, Dr Sujit Kumar Dey
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.41
Abstract
Background: Acute kidney injury (AKI) is a leading cause of 5-7% of inpatients wards and 30% of all ICU patients with high morbidity and mortality. The need for early detection of renal injury has recently lead to identification of several biomarkers of AKI, that have been found elevated with clinical AKI, in some cases prior to a gold standard diagnostic threshold(rise in serum creatinine by 50%).
Objectives: In search of biomarkers to detect AKI earlier & stratify its risk; cystatin C, Lactate dehydrogenase (LDH), Alkaline phosphatase (ALP), IL-6, IL-18 & Uric acid (UA) were tested from patients’ serum after satisfying all inclusion & exclusion criterias.
Materials & Methods: ELISA (Enzyme Linked Immuno Sorbent Assay) for cystatin C, IL-6, IL-18 and autoanalyzer for LDH, UA, ALP were used to assay them.
Results: 83.72% of stage 1(Acute Kidney Injury Network system) was found among 61.4% of high risk AKI patients. Maximum rise in creatinine occurs early after 24 hrs, which gradually declines in subsequent days. Level of all biomarkers rise in post operative period from 1.2 to 4 times of baselines. Day 1 UA >4.62mg/dl & >17.36% rise from baseline, rise in cystatin C & IL-18 by 94.23% and 23.4% respectively were set as cut-off to predict AKI. Baseline serum creatinine is the strongest predictor of creatinine at 3 &6 months, while baseline cystatin C has found to be moderate strength of prediction from our study.
Keywords: AKI, Cystatin C, LDH, ALP, IL-6, IL-18, UA.
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