The use of urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin for diagnosis of hepato-renal syndrome in advanced cirrhotic patients.

IF 3 3区医学 Q1 UROLOGY & NEPHROLOGY Renal Failure Pub Date : 2024-12-01

Mohamed Adel Abd Elaziz, Asmaa Mustafa Gouda Elewa, Dina Zaki Mohamed Zaki Abdel Hamid, Nohier Essam Soliman Ahmed Hassan, Éva Csongrádi, Emad Hamdy Hamouda Mohammed, Mohammed Abdel Gawad

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Abstract

Background: Chronic liver disease is a common and important clinical problem.Hepatorenal syndrome (HRS) is a life threatening complication. Serum creatinine (Cr) remains the only conventional indicator of renal function. However, the interpretation of serum Cr level can be confounded by malnutrition and reduced muscle mass often observed in patients with severe liver disease. Here, we present a cross-sectional study to explore the sensitivity and specificity of other markers as urinary KIM-1 and NGAL for cases of HRS.

Methods: Cross-sectional study was conducted on 88 patients who were admitted to Alexandria main university hospital. Enrolled patients were divided in two groups; group 1: patients with advanced liver cirrhosis (child B and C) who have normal kidney functions while group 2: patients who developed HRS. Stata© version 14.2 software package was used for analysis.

Results: Group 1 included 18 males and 26 females compared to 25 males and 19 females in group 2 (p = 0.135). Only the urinary KIM-1 showed a statistically significant difference between both groups in the multivariate logistic regression analysis adjusted for gender, serum bilirubin, serum albumin, INR, serum K, AST and ALT levels.

Conclusion: In conclusion, our study aligns with prior research, as seen in the consistent findings regarding Urinary NGAL elevation in cirrhotic patients with AKI. Urinary KIM-1, independent of Urinary NGAL, may have a role in precisely distinguishing between advanced liver cirrhosis and HRS and merits further exploration.

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使用尿肾损伤分子-1 和中性粒细胞明胶酶相关脂质体蛋白诊断晚期肝硬化患者的肝肾综合征。

背景：肝肾综合征（HRS）是一种威胁生命的并发症。血清肌酐（Cr）仍然是肾功能的唯一常规指标。然而，严重肝病患者常出现的营养不良和肌肉质量下降可能会影响血清肌酸酐水平的解释。在此，我们进行了一项横断面研究，探讨尿 KIM-1 和 NGAL 等其他指标对 HRS 病例的敏感性和特异性：方法：横断面研究针对亚历山大主要大学医院收治的 88 名患者。入组患者分为两组：第一组：肾功能正常的晚期肝硬化患者（B 型和 C 型）；第二组：发生 HRS 的患者。分析使用 Stata© 14.2 版软件包：第 1 组包括 18 名男性和 26 名女性，而第 2 组包括 25 名男性和 19 名女性（P = 0.135）。在调整性别、血清胆红素、血清白蛋白、INR、血清 K、AST 和 ALT 水平后进行的多变量逻辑回归分析中，只有尿 KIM-1 在两组间存在显著统计学差异：总之，我们的研究与之前的研究结果一致，这体现在肝硬化 AKI 患者的尿 NGAL 升高方面。尿 KIM-1 与尿 NGAL 无关，可能有助于准确区分晚期肝硬化和 HRS，值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Renal Failure 医学-泌尿学与肾脏学

CiteScore

3.90

自引率

13.30%

发文量

374

审稿时长

1 months

期刊介绍： Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.