Acute Kidney Injury Prediction Model Using Cystatin-C, Beta-2 Microglobulin, and Neutrophil Gelatinase-Associated Lipocalin Biomarker in Sepsis Patients

Figures & data

Table 1 Characteristics of Patient Included in This Study

	Healthy Participants (n=23)	Sepsis with Acute Kidney Injury (n=48)	Sepsis with no Acute Kidney Injury (n = 59)
Age	32.91±6.40	57.58±13.30	58.10±17.00
Gender (n, %)
Male	5 (21.74%)	35 (72.92%)	29 (49.15%)
Female	18 (78.26%)	13 (27.08%)	30 (50.85%)
Hemoglobin (g/dL)	13.59 ± 1.46	11.31 ± 2.90	10.1 ± 2.52
Hematocrit (%)	41.34 ± 4.31	34.05 ± 8.38	28.91 ± 10.40
MCHC (g/dL)	32.86 ± 0.65	33.31 ± 2.03	32.80 ± 2.39
Red Cell Distribution Width (fL)	10.84 ± 1.16	12.02 ± 3.25	12.40 ± 3.13
Leukocyte (×10^3/mm^3)	8.17 ± 2.02	17.90 ± 9.05	17.90 ± 11.3
Thrombocyte (×10^3/mm^3)	298.17 ± 48.15	262.20 ± 156.16	251.45 ± 169.40
Platelet Distribution Width (fL)	10.84 ± 1.16	12.02 ± 3.25	12.40 ± 3.13
Absolute neutrophil (×10^3/µL)	5.12 ± 1.82	17.74 ± 12.72	16.39 ± 15.12
Absolute lymphocyte (×10^3/µL)	2.46 ± 0.64	1.50 ± 1.19	1.45 ± 2.30
Neutrophil-to-Lymphocyte Ratio (%)	2.22 ± 0.97	15.99 ± 10.77	25.19 ± 30.68
Random Blood Sugar (mg/dL)	105.43 ± 23.22	139.08 ± 78.91	161.42 ± 105.54
Ureum (mg/dL)	17.94 ± 5.40	122.71 ± 70.72	108.68 ± 89.51
Creatinine (mg/dL)	0.78 ± 0.10	2.93 ± 1.68	2.41 ± 2.32
SGOT (U/L)	23.26 ± 13.39	215.27 ± 434.38	95.00 ± 185.49
SGPT (U/L)	24.08 ± 23.36	149.91 ± 323.38	95.94 ± 408.79
Total bilirubin (mg/dL)	0.19 ± 0.06	2.07 ± 5.11	1.93 ± 4.26
Albumin (mg/dL)	4.27 ± 0.41	2.90 ± 0.56	2.50 ± 0.63
Natrium (mmol/L)	138.0 ± 8.32	136.91 ± 8.27	134.88 ± 8.56
Potassium (mmol/L)	4.09 ± 0.37	4.66 ± 0.99	4.23 ± 1.11
Chloride (mmol/L)	102.56 ± 5.58	106.95 ± 9.65	102.15 ± 9.54

Note: *Characteristics are shown in mean ± SD, unless otherwise noted.

Table 2 List of Common Biomarkers Used in This Study

Hemoglobin (g/dL)

Hematocrit (%)

MCHC (g/dL)

Red Cell Distribution Width (fL)

Leukocyte (×10^3/mm^3)

Thrombocyte (×10^3/mm^3)

Platelet Distribution Width (fL)

Absolute neutrophil (×10^3/µL)

Absolute lymphocyte (×10^3/µL)

Neutrophil-to-Lymphocyte Ratio (%)

Random Blood Sugar (mg/dL)

Urea (mg/dL)

Creatinine (mg/dL)

SGOT (U/L)

SGPT (U/L)

Total bilirubin (mg/dL)

Albumin (mg/dL)

Natrium (mmol/L)

Potassium (mmol/L)

Chloride (mmol/L)

Table 3 Renal-Associated Biomarkers Result

	Normal (n=23)	Sepsis with Acute Kidney Injury (n=48)	Sepsis with No Acute Kidney Injury (n = 59)	p-value
Beta-2 Microglobulin (pg/mL)	1.64 ± 0.24	7.83 ± 3.55	7.27 ± 3.95	0.000*
Cystatin C (mg/dL)	0.83 ± 0.61	0.94 ± 1.16	0.66 ± 0.50	0.080
NGAL (ng/mL)	53.82 ± 20.87	109.87 ± 145.50	70.98 ± 44.11	0.034*

Notes: Characteristics are shown in mean ± SD unless otherwise noted. *Denotes significance.

Abbreviation: NGAL, Neutrophil Gelatinase-Associated Lipocalin.

Table 4 Sensitivity, Specificity, PPV, and NPV of Each Parameter Using ROC Curve-Based Cut-off

	Cut Off	Sensitivity	Specificity	PPV	NPV
Beta-2 Microglobulin (pg/mL)	7.540	60.40%	73.20%	56.86%	75.95%
Cystatin C (mg/dL)	0.531	54.20%	51.20%	39.39%	65.63%
NGAL (ng/mL)	60.706	66.70%	59.80%	49.23%	75.38%

Table 5 Diagnostic Test Parameters for the Machine-Learning Parameters of Acute Kidney Injury

	AUC	Sensitivity	Specificity	Negative Predictive Value	Positive Predictive Value
Support Vector Machine (SVM)	0.794	50%	94.4%	71.4%	87.5%
Naïve Bayes	0.743	83.3%	77.8%	87.5%	71.4%