Ann Surg Treat Res.  2015 May;88(5):281-288. 10.4174/astr.2015.88.5.281.

Evaluation of diagnostic biomarkers for acute kidney injury in major burn patients

• Kym D
• Cho YS
• Yoon J
• Yim H
• Yang HT

• KMID: 2166997
• DOI: http://doi.org/10.4174/astr.2015.88.5.281

Abstract

PURPOSE
Acute kidney injury (AKI) in major burn patients is a common complication with high morbidity and mortality. The mainstream treatment is early diagnosis and rapid termination and prevention of the underlying insult. Therefore, it's essential to identify early biomarkers predicting AKI.
METHODS
A total of 85 patients who were admitted to the burn intensive care unit from June 2012 to July 2013 were included in this prospective cohort study. Ten biomarkers (blood urea nitrogen, serum creatinine, urine creatinine, cystatin C, cystatin C glomerular filtration rate, AST, lacate dehydrogenase [LD], creatine kinase, lactic acid, and myoglobin) were obtained at time of admission and evaluated as diagnostic biomarkers to predicting AKI and early AKI.
RESULTS
Out of 85 patients, 35 patients were dead and overall mortality was 41.2%. The mean age was 49.4 years and mean percentage of total body surface area was 53.2%. Area under the curve (AUC) of receiver operating characteristic curve of biomarkers on predicting AKI were 0.746, 0.718, and 0.717 in LD, lactic acid, and serum creatinine, respectively. AUC of cystatin C predicting AKI was much lower at 0.555. AUC of biomarkers on predicting early AKI were 0.833, 0.816, 0.790, and 0.759 in LD, serum creatinine, AST, and serum myoglobin.
CONCLUSION
LD, lactic acid and serum creatinine were acceptable as diagnostic biomarkers of AKI and LD, serum creatinine, AST, and serum myoglobin were reasonable as diagnostic biomarkers of early AKI. However, cystatin C was an unfavorable biomarker in major burn patients.

Keyword

Acute kidney injury; Biological biomarker; Burns; Cystatin C; Lactate dehydrogenase

MeSH Terms

Acute Kidney Injury*
Area Under Curve
Biomarkers*
Body Surface Area
Burns*
Cohort Studies
Creatine Kinase
Creatinine
Cystatin C
Early Diagnosis
Glomerular Filtration Rate
Humans
Intensive Care Units
L-Lactate Dehydrogenase
Lactic Acid
Mortality
Myoglobin
Nitrogen
Oxidoreductases
Prospective Studies
ROC Curve
Urea
Creatine Kinase
Creatinine
Cystatin C
L-Lactate Dehydrogenase
Lactic Acid
Myoglobin
Nitrogen
Oxidoreductases
Urea

Figure

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  Fig. 1 The receiver operating characteristic (ROC) curves. (A) Lactate dehydrogenase (LD), lactic acid, serum creatinine, AST and serum myoblogin on diagnosis of overall acute kidney injury (AKI). (B) LD, serum creatinine, AST, serum myoglobin, lactic acid and cystatin C on diagnosis of early AKI.

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