Original article (Clinical research)

Study on early diagnosis of acute decompensated heart failure combined with acute renal injury

  • YUAN Fang ,
  • LIU Hua ,
  • WANG Wen-xia ,
  • et al
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  • Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China

Online published: 2014-12-30

Supported by

Science and Technology Foundation of Shanghai Municipal Health Bureau, 20114324

Abstract

Objective To evaluate the value of new biological indicators of acute kidney injury (AKI) for early diagnosis of acute decompensated heart failure (ADHF) combined with AKI, i.e. cardiorenal syndrome type 1 (CRS1). Methods A total of 200 patients with ADHF were enrolled. Levels of baseline serum creatinine (SCr), serum combination [neutrophil gelatinase associated lipocalin (NAGL) and Cystatin C (CysC)], and urine combination [NAGL and kidney injury molecule-1(KIM-1)] were detected. Levels of serum combination and urine combination were redetected after 6 h and 18 h and the level of SCr was redetected after 48 h. According to the criteria, CRS1 patients were selected. The correlations of serum and urine NAGL, serum CysC, urine KIM-1, and Scr were analyzed. According to receiver operating characteristic (ROC) curve, the cut-off value, sensitivity, specificity, and the area under the ROC curve (AUC) of NAGL, Cys C and KIM-1 at 6 h and 18 h for diagnosing AKI were obtained. The AUC of serum combination (NAGL,Cys C) and urine combination (NAGL,KIM-1) at 6 h and 18 h for diagnosing AKI was calculated. Results According to the diagnostic criteria of CRS1, 48 of 200 ADHF patients were diagnosed with AKI and the incidence was 24%. Serum NAGL at 6 h and serum Cys C at 18 h positively correlated with Scr (r=0.857, P<0.05; r=0.869, P<0.05). Urine NAGL and KIM-1 at 6 h positively correlated with Scr (r=0.756, P<0.05; r=0.742, P<0.05). The AUCs of serum combination at 6 h and 18 h were 0.87 and 0.89, while the AUCs of urine combination at 6 h and 18 h were 0.92 and 0.93. Conclusion Serum and urine NAGL, serum Cys C, and urine KIM-1 can be used as early diagnostic indicators for CRS1 patients. Combined detection of urine NAGL and KIM-1 may improve the sensitivity and specificity of early diagnosis of CRS1.

Cite this article

YUAN Fang , LIU Hua , WANG Wen-xia , et al . Study on early diagnosis of acute decompensated heart failure combined with acute renal injury[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2014 , 34(12) : 1771 . DOI: 11.3969/j.issn.1674-8115.2014.12.013

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