JOURNAL OF PRACTICAL HEPATOLOGY ›› 2019, Vol. 22 ›› Issue (3): 385-388.doi: 10.3969/j.issn.1672-5069.2019.03.019

• Liver cirrhosis • Previous Articles     Next Articles

Predictive value of urinary NGAL and KIM-1 for response of patients with hepatorenal syndrome to terlipressin combined with albumin infusion treatment

Xu Manman, Chen Yu, Li shuang   

  1. You' an Hospital, Capital Medical University, Beijing 100069
  • Received:2018-06-10 Online:2019-05-10 Published:2019-05-15

Abstract: Objectiv To explore the predictive value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) and urine kidney injury factor-1 (KIM-1) for response of patients with hepatorenal syndrome (HRS) to terlipressin combined with albumin infusion treatment. Methods 19 consecutive patients with liver cirrhosis complicated by HRS type one were recruited in You'an hospital between May 1,2017 and April 30,2018,and all the patients received terlipressin and albumin infusion treatment. Urine NGAL and KIM-1 were detected by ELISA. Results At the end of four day treatment,12 (63.2%) responded and 7(36.8%) did not;the age (P=0.605) and gender (P=0.386),the incidences of spontaneous bacterial peritonitis(P=0.526) and gastrointestinal hemorrhage (P=0.525),and serum ALT,AST,bilirubin,blood urea nitrogen,and platelet cell counts,hemoglobin levels and while blood cell counts between the two groups were not significantly different (P>0.05);the prothrombin time activity(PTA) in responded patients was much higher(P=0.006),and serum Cr level was significantly lower than in patients non-responded(P=0.043);uNGAL/Cr was 21.8(7.8~65.5) μg/g and uKIM-1/Cr was 4.9(2.0~7.7) μg/g in responded patients,much lower than 97.8(27.1~358.2) μg/g (P=0.010) and 9.1(5.5~13.6) μg/g (P=0.001) in non-responded patients;the 90 d survival in responded patients was 75.0%,not significantly different as compared to 42.9% in non-responded patients(P=0.182);serum Cr was positively correlated to uNGAL/Cr(r=0.549,P=0.022),while was not significantly correlated to uKIM-1/Cr(r=0.213,P=0.411). Conclusion Baseline blood creatinine,PTA and urine NGAL levels might predict the response of patients with HRS to combination of terlipressin and albumin infusion,which warrants further investigation.

Key words: Liver cirrhosis, Hepatorenal syndrome, Terlipressin, Urinary neutrophil gelatinase-associated lipocalin, Urine kidney injury factor-1, Prediction