Evaluation of clinically available renal biomarkers in critically ill adults: a prospective multicenter observational study

Table 3 Detective characteristics of the three biomarkers and their combinations for total acute kidney injury and severe acute kidney injury

Logistic regression model	AUC-ROC^a	Cutoff^b	Sensitivity	Specificity	(+) LR	(−) LR	PPV	NPV
Total AKI (n = 326)
Univariate models
sCysC	0.738 (0.703–0.772)	1.26 mg/L	0.44	0.95	7.92	0.59	0.77	0.80
uNAG	0.650 (0.614–0.686)	27.14 U/g Cre	0.64	0.60	1.59	0.60	0.41	0.80
uACR	0.683 (0.648–0.718)	61.14 mg/g Cre	0.54	0.76	2.20	0.61	0.49	0.79
Multivariate models
sCysC + uNAG	0.756 (0.723–0.789)^c	0.43^d	0.49	0.91	5.69	0.56	0.71	0.81
uNAG + uACR	0.661 (0.626–0.697)^e	0.27^d	0.64	0.62	1.68	0.58	0.42	0.80
sCysC + uACR	0.740 (0.706–0.774)^f	0.45^d	0.45	0.94	7.66	0.59	0.77	0.80
Severe AKI (n = 102)
Univariate models
sCysC	0.839 (0.798–0.880)	1.25 mg/L	0.67	0.87	5.28	0.38	0.35	0.96
uNAG	0.706 (0.651–0.761)	32.80 U/g Cre	0.72	0.65	2.03	0.44	0.17	0.96
uACR	0.771 (0.726–0.817)	71.97 mg/g Cre	0.72	0.74	2.77	0.38	0.22	0.96
Multivariate models
sCysC + uNAG	0.863 (0.827–0.900)^c	0.09^d	0.76	0.83	4.39	0.28	0.31	0.97
uNAG + uACR	0.715 (0.661–0.768)^g	0.08^d	0.74	0.64	2.06	0.41	0.18	0.96
sCysC + uACR	0.838 (0.797–0.879)^f	0.08^d	0.78	0.75	3.16	0.29	0.25	0.97

Abbreviations: (+) LR Positive likelihood ratio, (−) LR negative likelihood ratio, PPV Positive predictive value, NPV Negative predictive value, sCysC Serum cystatin C, uNAG Urinary N-acetyl-β-d-glucosaminidase, Cre Creatinine concentration, uACR Urinary albumin/creatinine ratio
^a Values are presented as AUC-ROC (95% CI)
^b Ideal cutoff value according to Youden’s index
^c P < 0.05 vs. sCysC, uNAG, uACR, uNAG + uACR, and sCysC + uACR
^d Cutoff points of the biomarker panels were the predicted probabilities generated from the multiple logistic regression model
^e P < 0.05 vs. sCysC, uNAG, sCysC + uACR, and sCysC + uNAG
^f P < 0.05 vs. uNAG, uACR, uNAG + uACR, and sCysC + uNAG
^g P < 0.05 vs. sCysC, uNAG, uACR, sCysC + uACR, and sCysC + uNAG

ISSN: 1364-8535