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Renal arterial resistive index, monocyte chemotactic protein 1 and neutrophil gelatinase-associated lipocalin, for predicting acute kidney injury in critically ill cancer patients

  • Nephrology - Original Paper
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Abstract

Purpose

We evaluated the renal arterial resistive index (RRI), urine monocyte chemotactic protein 1 (uMCP-1), and urine neutrophil gelatinase-associated lipocalin (uNGAL) to predict acute kidney injury (AKI) in critically ill cancer patients.

Methods

In this prospective study, we included patients without AKI. We compared the area under the curve (AUC) of RRI, uMCP-1, and uNGAL to predict any stage of AKI and stage-3 AKI with the DeLong method, and we established cutoff points with the Youden index.

Results

We included 64 patients, and 43 (67.2%) developed AKI. The AUC to predict AKI were: 0.714 (95% CI 0.587–0.820) for the RRI, 0.656 (95% CI 0.526–0.770) for uMCP-1, and 0.677 (95% CI 0.549–0.789) for uNGAL. The AUC to predict stage-3 AKI were: 0.740 (95% CI 0.615–0.842) for the RRI, 0.757 (95% CI 0.633–0.855) for uMCP-1, and 0.817 (95% CI 0.701–0.903) for uNGAL, without statistical differences among them. For stage 3 AKI prediction, the sensitivity and specificity were: 56.3% and 87.5% for a RRI > 0.705; 70% and 79.2% for an uMCP-1 > 2169 ng/mL; and 87.5% and 70.8% for a uNGAL > 200 ng/mL. The RRI was significantly correlated to age (r = 0.280), estimated glomerular filtration rate (r = − 0.259), mean arterial pressure (r = − 0.357), and serum lactate (r = 0.276).

Conclusion

The RRI, uMCP-1, and uNGAL have a similar ability to predict AKI. The RRI is more specific, while urine biomarkers are more sensitive to predict stage 3 AKI. The RRI correlates with hemodynamic variables. The novel uMCP-1 could be a useful biomarker that needs to be extensively studied.

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Acknowledgements

This study was performed in fulfillment of the Doctorate Program in Medical, Dental, and Health Sciences of the Universidad Nacional Autónoma de México (UNAM). Doctor Bertha M. Córdova-Sánchez is a Ph.D. Candidate from this program.

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Authors and Affiliations

  1. Instituto Nacional de Cancerología, Mexico City, Mexico

    Bertha M. Córdova-Sánchez, Silvio A. Ñamendys-Silva, Irlanda Pacheco-Bravo, Francisco Javier García-Guillén, Gustavo Barraza-Aguirre, Walter Oswaldo Ramírez-Talavera, Adán R. López-Zamora, Fernando Monera-Martínez & Luis Jesús Vidal-Arellano

  2. Nephrology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan, C. P. 14080, Mexico City, Mexico

    Silvio A. Ñamendys-Silva, Juan Manuel Mejía-Vilet, Cristino Cruz & Luis Eduardo Morales-Buenrostro

  3. Hospital Medica Sur, Mexico City, Mexico

    Silvio A. Ñamendys-Silva & Luis Eduardo Morales-Buenrostro

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  1. Bertha M. Córdova-Sánchez
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Correspondence to Luis Eduardo Morales-Buenrostro.

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The authors declare that they have no competing interests. The authors declare that they have no sources of funding to declare.

Ethical approval

The protocol was approved by the local Institutional Review Board (Record CEI/1283/18). Before inclusion, we obtained informed consent from the responsible family members, since the patients were under sedation.

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Córdova-Sánchez, B.M., Ñamendys-Silva, S.A., Pacheco-Bravo, I. et al. Renal arterial resistive index, monocyte chemotactic protein 1 and neutrophil gelatinase-associated lipocalin, for predicting acute kidney injury in critically ill cancer patients. Int Urol Nephrol 55, 1799–1809 (2023). https://doi.org/10.1007/s11255-023-03504-5

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