Urinary netrin-1 and KIM-1 as early biomarkers for septic acute kidney injury

Figures & data

Table 1. Subjects’ characteristics.

	AKI	Non-AKI	Control
Number	49	101	50
Gender (M/F)	33/16	60/41	30/20
Age	58 ± 9	57 ± 10	56 ± 11
Weight (Kg)	63.39 ± 21.25	60.72 ± 19.53	58.83 ± 17.92
Sepsis causes
Pneumonia	36	51
Abdominal,  biliary infection	6	20
UTI	1	9
Cellulitis	1	5
Others	5	16
Comorbidities
CAD	6	15
Stroke	5	10
COPD	13	19
Diabetes	8	9
Trauma	5	16
Surgery	7	21
Hematologic disease	4	5
APACHE II	19.85 ± 7.23	17.21 ± 6.15
CRRT	35	18
ICU length of stay (days)	9.78 ± 3.01†	5.36 ± 1.87
Mortality	29/49 (59%)*	20/101 (20%)

Notes: AKI: acute kidney injury; CRRT: Continuous renal replacement therapy; APACHE II: Acute Physiology and Chronic Health Evaluation II; CAD: Coronary Artery Disease; COPD: Chronic obstructive pulmonary disease.

†p < 0.05, *p < 0.001 compared to non-AKI group.

Figure 1. Changes of serum creatinine (SCr) levels at various time points after ICU admission in septic AKI and non-AKI patients. Two-way ANOVA followed by Bonferroni post hoc test was used here. Note: *p < 0.05.

Figure 2. Changes of urinary netrin-1 levels at various time points after ICU admission in septic AKI and non-AKI patients. Two-way ANOVA followed by Bonferroni post hoc test was used here. Note: *p < 0.05.

Figure 3. Changes of human kidney injury molecule type 1 (KIM-1) levels at various time points after ICU admission in septic AKI and non-AKI patients. Two-way ANOVA followed by Bonferroni post hoc test was used here. Note: *p < 0.05.

Table 2. Comparative diagnostic performance characteristics of netrin-1 and KIM-1 for the septic AKI using the area under the curve.

	Netrin-1			KIM-1
	AUC (95% CI)	Sensitivity	Specificity	AUC (95% CI)	Sensitivity	Specificity
0 h	0.279 (0.215,0.344)	40%	30%	0.299 (0.230,0.368)	48%	18%
1 h	0.799 (0.758,0.839)	85%	61%	0.471 (0.418,0.524)	50%	40%
3 h	0.858 (0.826,0.891)	91%	64%	0.476 (0.397,0.556)	46%	50%
6 h	0.833 (0.797,0.869)	91%	62%	0.864 (0.822,0.906)	94%	61%
24 h	0.770 (0.713,0826)	78%	61%	0.916 (0.891,0.942)	91%	78%
48 h	0.546 (0.492,0.599)	48%	35%	0.872 (0.839,0.905)	89%	62%

Table 3. SCr, urinary netrin-1 and KIM-1 levels between non-survivors and survivors.

	SCr			Netrin-1			KIM-1
Time points (hr)	Non-survivors	Survivors	p	Non-survivors	Survivors	p	Non-survivors	Survivors	p
0	71.75 ± 14.27	69.58 ± 13.25	0.5928	2.07 ± 0.82	2.31 ± 0.95	0.3501	0.87 ± 0.25	0.83 ± 0.23	0.5725
1	72.28 ± 15.91	70.64 ± 13.16	0.7059	6.25 ± 1.74	5.68 ± 1.49	0.2388	0.92 ± 0.36	0.88 ± 0.32	0.6846
3	77.31 ± 16.15	73.89 ± 15.37	0.4613	21.02 ± 6.32	18.13 ± 5.97	0.1144	0. 92 ± 0.16	0. 87 ± 0.15	0.2700
6	83.16 ± 19.64	78.23 ± 18.49	0.3811	17.49 ± 5.15	15.36 ± 4.89	0.1531	13.25 ± 3.39	11.76 ± 3.28	0.1322
24	136.63 ± 27.78	140.70 ± 30.16	0.6287	8.12 ± 1.95	7.35 ± 1.66	0.1562	46.89 ± 15.27	35.67 ± 11.34	0.0075†
48	170.63 ± 36.52	158.25 ± 37.13	0.2772	3.21 ± 1.15	2.87 ± 1.06	0.2993	21.53 ± 6.29	16.66 ± 5.07	0.0061†

Notes: SCr: serum creatinine; KIM-1: kidney injury molecule type 1.

†p Values are statistically significant.