Significance of Serum and Urine NGAL,KIM-1 Levels in the Diagnosis of Urinary System Disease-induced Acute Kidney Injury in Children

Objective To determine the role of serum and urinary neutrophil gelatinase-associated lipocalin(NGAL) and kidney injury molecule-1(KIM-1)in the diagnosis of urinary system disease induced acute kidney injury(AKI)in children.Methods A prospective clinical study was performed which involved 102 children admitted to Department of Pediatic Nephrology,Shengjing Hospital.Patients were classified by the pediatric modified RIFLE(pRIFLE) criteria for AKI.Serum and urinary NGAL and KIM-1 were detected by ELISA method.The sensitivity and specificity of NGAL and KIM-1 in children with AKI in early stage was evaluated using ROC curve analysis.For these patients who had already been diagnosed AKI,NGAL and KIM-1 were also detected on day 1,4,7,and the correlation analysis was performed with corresponding serum creatinine.Results A total of 102 patients were enrolled in the study,43 patients were diagnosed AKI including 18 AKI-R,10 AKI-I,and 15 AKI-F.Serum and urinary NGAL,KIM-1 was elevated before serum creatinine in the patients with AKI and there was statistically significant difference compared with non AKI group and normal group.ROC curve analysis showed the area under the curve of serum NGAL was 0.89(95% CI 0.65-0.91)and urinary NGAL was 0.84(95% CI 0.62-0.90)which were better than KIM-1.Correlations between serum,urinary NGAL and serum creatinine were observed with coefficients at r =0.79(P 0.01)and r =0.62(P 0.01),respectively.Correlation coefficients between serum,urinary KIM-1 and serum creatinine were r =0.52(P 0.05),r =0.55(P 0.05),respectively.Conclusion Serum and urinary NGAL and KIM-1 were elevated in the children with AKI before serum creatinine,which could be the early biomarker for AKI diagnosis,In addition,these two indicators are correlated with serum creatine in the event of AKI.