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  • Author: Cuma Mertoglu x
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Cuma Mertoglu, Murat Gunay, Ali Gurel and Mehmet Gungor

Summary

Background: Due to the lack of diagnostic efficiency of serum creatinine in acute kidney injury (AKI), there is a pressing need to develop novel diagnostic markers. Therefore, in this study, we evaluated myo-inositol oxygenase (MIOX), neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in terms of their applicability in the diagnosis of AKI. Methods: We enrolled a total of 39 AKI patients and 38 healthy controls in the study. We compared the levels of serum MIOX, NGAL and cystatin C between the two groups. Results: We found that the concentrations of serum creatinine, blood-urea nitrogen, MIOX and cystatin C were higher in the AKI group. According to the receiver operating characteristic analysis, the area under the curve (AUC) values were 0.694 (95% CI 0.579-0.794) for MIOX and 0.976 (95% CI; 0.912-0.997) for cystatin C. For MIOX, when the cut-off concentration was set to 77.3 pg/mL, the diagnostic sensitivity and specificity were found to be 53.8% (95% CI; 37.2-69.9) and 81.5 (95% CI; 65.7-92.3), respectively. For cystatin C, at the cut-off value of 14 mg/L, the diagnostic sensitivity and specificity were 94.8% (95% CI; 82.7-99.4) and 94.7 % (95% CI 82.3-99.4), respectively. Conclusion: The measurement of serum MIOX and cystatin C levels is valuable for the diagnosis of AKI. Further research is needed for the evaluation of the potential use of MIOX as a kidney-specific enzyme in the early diagnosis of AKI.

Open access

Cuma Mertoglu, Murat Gunay, Ali Gurel, Mehmet Gungor and Vahdet Gul

Abstract

Purpose: Acute kidney injury (AKI) is a severe kidney disease carrying high morbidity and mortality. An ischemic process, at the cellular level, has been detected prior to the full-blown AKI. An elevated ischemic modified albumin (IMA) was also found to be increased fast at several minutes following an ischemic process in the body. In this connection, we have investigated, in advance, the changes of IMA concentrations in patients with possible AKI. Methods: IMA and other biochemical and haematological parameters were measured in sera of thirty nine patients with AKI and of thirty eight healthy controls. AKI is defined by an increase in serum creatinine by ≥ 0.3 mg/dl in 48 hours or an increase by ≥ 1.5-fold from a known or assumed baseline. The results in the two groups were compared. Results: IMA, creatinine, blood urea nitrogen, white blood cell, neutrophil, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume were found to be higher in patients with AKI than in healthy controls. In contrast, total protein, albumin, lymphocyte, and haemoglobin were lower in patients with AKI than in healthy controls. No significant difference was recorded in platelet counts between the two groups. Conclusion: Our results indicate that increased levels of NLR and PLR play a central role in a systemic inflammation in AKI. Monitoring serum IMA could be a useful tool in the assessment of AKI.