Predictive value of NGAL and renal injury molecule 1 in 28-day mortality of neonatal sepsis with re-nal injury / 中国医师杂志

ABSTRACT

Objective To investigate the prognostic value of serum neutrophil gelatinase-associated lipid transport protein (NGAL) and renal injury molecule 1 (KIM-1) in assessing neonatal sepsis with a-cute renal injury. Methods A total of 63 cases of renal injury with neonatal sepsis was collected from De-partment of Pediatrics, Affiliated Children's Hospital of Capital Institute of Pediatrics. The general condition of the patients, and neonatal critical case score ( NCIS) were recorded. The expressions of NGAL and KIM-1 in serum of all children were measured by venous blood and urine. Each case was followed up for 28 days to track the death of newborns. Pearson correlation analysis was used to test the correlation among NGAL, KIM-1, and NCIS;Multivariate regression analysis was used for NGAL, KIM-1, and other risk factors asso-ciated with neonatal sepsis kidney injury 28 days mortality. Receiver operating characteristic ( ROC) curve was used to compare the value of NGAL and KIM-1 in the prognosis of neonatal sepsis renal injury. The val-ues of NGAL and KIM-1 in the prognosis of neonatal sepsis renal injury were analyzed by ROC curve. Re-sults ⑴ After 28 days of follow-up, 63 cases of neonatal sepsis, and 22 died were found, which was ac-counted for 34. 92 percent of the total. ⑵ Compared to the survival group, the expressions of NGAL and KIM-1 in the death group were increased ( P<0. 01 ) . ⑶ Pearson correlation analysis showed that NGAL and KIM-1 expressions in peripheral blood were negatively correlated with NCIS. ⑷Multivariate regression analysis showed that NGAL and KIM-1 were independent risk factors for neonatal sepsis kidney injury ( P<0. 01). ⑸ ROC curve analysis showed that the area under the curve of NGAL and KIM-1 was 0. 79 (95％CI0. 75-0. 93), and 0. 84 (95％ CI0. 71-0. 90), NGAL and KIM-1 were better than single detection with NGAL, or KIM-1, area under curve (AUC) was 0. 89 (95％ CI0. 78-0. 94) (P<0. 01). Sensitiv-ity of KIM-1 was superior to that of NGAL, and specificity of NGAL was superior to KIM-1. The sensitivity and specificity of both were better than single detection with NGAL and KIM-1. Conclusions NGAL and KIM-1 have good predictive value in assessing neonatal sepsis kidney injury mortality.