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>Serum cystatin C: A potential predictor for hospital-acquired acute kidney injury in patients with acute exacerbation of COPD
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Serum cystatin C: A potential predictor for hospital-acquired acute kidney injury in patients with acute exacerbation of COPD
Hospital-acquired acute kidney injury (HA-AKI) is associated with poor prognosis. In this study, we evaluated whether serum cystatin C on admission could predict AKI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The retrospective study was conducted using data on adult inpatients with AECOPD from January 2014 to January 2017. A total of 1035 patients were included, among which 79 (7.6%) with HA-AKI were identified. Univariate and multivariate logistic regression analyses were used to investigate predictors of HA-AKI in patients with AECOPD. HA-AKI was associated with poor prognosis, and patients with HA-AKI had higher inpatient mortality (34.2% vs. 2.6%, p 0.001). Furthermore, after adjusting for confounders, HA-AKI was an independent risk factor for inpatient mortality for patients with AECOPD (odds ratio (OR) 11.02; 95% confidence interval (CI) 4.77–25.45; p 0.001). Four independent risk factors for HA-AKI (age, levels of urea and cystatin C, and platelet count on admission) were identified in patients with AECOPD. Cystatin C (OR 5.22; 95% CI 2.49–10.95; p 0.001) was a significant independent predictor of AKI in patients with AECOPD. HA-AKI in patients with AECOPD could be identified with a sensitivity of 73.5% and a specificity of 75.9% (area under the curve (AUC) = 0.803, 95% CI 0.747–0.859) by cystatin C level (cutoff value = 1.3 mg/L) and with a sensitivity of 75.9% and a specificity of 82.0% (AUC = 0.853, 95% CI 0.810–0.896) using a model comprising all significant predictors. Serum cystatin C has the potential for use to predict the risk of HA-AKI in patients with AECOPD.
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机译：医院获得的急性肾损伤（HA-AKI）与预后差有关。在这项研究中，我们评估了血清胱抑素C是否可以预测慢性阻塞性肺病（AECOPD）急性加重患者的AKI。从2014年1月到2017年1月，使用ACOPD的成人住院患者进行了回顾性研究。共有1035名患者，其中鉴定了79例（7.6％）的HA-AKI。单变量和多变量逻辑回归分析用于调查艾彼浦患者HA-AKI的预测因子。 HA-AKI与预后差有关，HA-AKI患者的入住性死亡率较高（34.2％vs.2.6％，P <0.001）。此外，在调整混凝剂后，HA-AKI是AECOPD患者的住院性死亡率的独立危险因素（赔率比（或）11.02; 95％置信区间（CI）4.77-25.45; p <0.001）。 AECOPD患者中鉴定了4例HA-AKI（年龄，尿素和尿嘧啶C和胱抑素C和血小板计数）的独立危险因素。胱抑素C（或5.22; 95％CI 2.49-10.95; p <0.001）是AECOPD患者的AKI重要预测因子。通过胱抑素C水平鉴定患有73.5％的敏感性73.5％的敏感性73.5％，特异性为75.9％（AUC）= 0.803,95％CI 0.747-0.859）（截止值= 1.3mg） / L）和敏感性为75.9％，特异性为82.0％（AUC = 0.853,95％CI 0.810-0.896），该模型包括所有重要预测因子。血清胱抑素C具有潜力，以预测AECOPD患者HA-AKI的风险。
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