Variations of urinary N-acetyl-β-D-glucosaminidase levels and its performance in detecting acute kidney injury under different thyroid hormones levels: a prospectively recruited, observational study
Jiaxin Li,
Jia Deng,
Jing Xu,
Linling He,
Yufan Liang,
Linhui Hu,
Heng Fang,
Chunbo Chen,
Silin Liang,
Dandong Luo,
Miaoxian Fang,
Huidan Zhang
Affiliations
Jiaxin Li
Department of Critical Care Medicine, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
Jia Deng
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
Jing Xu
Department of Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, Guangdong Province, People’s Republic of China
Linling He
Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
Yufan Liang
Center of Scientific Research, Maoming People’s Hospital, 101 Weimin Road, Maoming 525000, Guangdong Province, People’s Republic of China
Linhui Hu
Department of Critical Care Medicine, Maoming People`s Hospital, Maoming, Guangdong, China
Heng Fang
Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
Chunbo Chen
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
Silin Liang
Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 96 Dongchuan Road, Guangzhou 510080, Guangdong Province, People’s Republic of China
Dandong Luo
Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 96 Dongchuan Road, Guangzhou 510080, Guangdong Province, People’s Republic of China
Miaoxian Fang
Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 96 Dongchuan Road, Guangzhou 510080, Guangdong Province, People’s Republic of China
Huidan Zhang
Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 96 Dongchuan Road, Guangzhou 510080, Guangdong Province, People’s Republic of China
Objective Changes in thyroid function will be accompanied by changes in urinary N-acetyl-β-D-glucosaminidase (uNAG) levels. Therefore, whether thyroid hormones interfere the ability of uNAG in detecting acute kidney injury (AKI) has raised concern in patients with critical illness.Design A prospectively recruited, observational study was performed.Setting Adults admitted to the intensive care unit of a grade A tertiary hospital in China.Participants A total of 1919 critically ill patients were enrolled in the study.Main outcome measures To investigate the variations of the ability of uNAG to detect AKI in patients with critical illness under different thyroid hormones levels (differences in area under the curve (AUC) for uNAG diagnosis and prediction of AKI with different thyroid hormones levels).Results The bivariate correlation analysis revealed that FT3 and TT3 levels were independently associated with uNAG levels (p<0.001). FT3 and uNAG also showed correlation in multivariable linear regression analysis (p<0.001). After stratification according to the levels of FT3 or TT3, significant variation was observed in the uNAG levels with different quartiles (p<0.05). However, in patients with varying FT3 and TT3 levels, no significant difference was found in the AUCs of uNAG to detect AKI (p>0.05).Conclusions Even if uNAG levels varied with FT3 and TT3 levels, these hormones did not interfere with uNAG’s ability to detect AKI in patients with critical illness.
