Acute Kidney Injury Prediction Model Using Cystatin-C, Beta-2 Microglobulin, and Neutrophil Gelatinase-Associated Lipocalin Biomarker in Sepsis Patients

Abstract

Hani Susianti,1 Aswoco Andyk Asmoro,2 Sujarwoto,3 Wiwi Jaya,2 Heri Sutanto,4 Amanda Yuanita Kusdijanto,1 Kevin Putro Kuwoyo,1 Kristian Hananto,5 Matthew Brian Khrisna1 1Clinical Pathology Department, Faculty of Medicine Brawijaya University/Saiful Anwar General Hospital, Malang, Indonesia; 2Anesthesiology and Intensive Therapy Department, Faculty of Medicine Brawijaya University/Saiful Anwar General Hospital, Malang, Indonesia; 3Faculty of Public Administration, Brawijaya University, Malang, Indonesia; 4Internal Medicine Department, Faculty of Medicine Brawijaya University/Saiful Anwar General Hospital, Malang, Indonesia; 5Faculty of Medicine, Brawijaya University, Malang, IndonesiaCorrespondence: Hani Susianti, Clinical Pathology Department, Medicine Faculty of Universitas Brawijaya/Dr. Saiful Anwar General Hospital, Malang, Indonesia, Email [email protected]: AKI is a frequent complication in sepsis patients and is estimated to occur in almost half of patients with severe sepsis. However, there is currently no effective therapy for AKI in sepsis. Therefore, the therapeutic approach is focused on prevention. Based on this, there is an opportunity to examine a panel of biomarker models for predicting AKI.Material and Methods: This prospective cohort study analysed the differences in Cystatin C, Beta-2 Microglobulin, and NGAL levels in sepsis patients with AKI and sepsis patients without AKI. The biomarker modelling of AKI prediction was done using machine learning, namely Orange Data Mining. In this study, 130 samples were analysed by machine learning. The parameters used to obtain the biomarker panel were 23 laboratory examination parameters.Results: This study used SVM and the Naïve Bayes model of machine learning. The SVM model’s sensitivity, specificity, NPV, and PPV were 50%, 94.4%, 71.4%, and 87.5%, respectively. For the Naïve Bayes model, the sensitivity, specificity, NPV, and PPV were 83.3%, 77.8%, 87.5%, and 71.4%, respectively.Discussion: This study’s SVM machine learning model has higher AUC and specificity but lower sensitivity. The Naïve Bayes model had better sensitivity; it can be used to predict AKI in sepsis patients.Conclusion: The Naïve Bayes machine learning model in this study is useful for predicting AKI in sepsis patients.Keywords: machine learning, sepsis, AKI, Cystatin C, Beta-2 Microglobulin, NGAL

Keywords

• machine learning
• sepsis
• aki
• cystatin c
• beta-2 microglobulin
• ngal