Predictive values of urinary RBP, L-FABP and serum Presepsin levels for acute kidney injury in patients with craniocerebral trauma after concurrent removal of cranial hematoma

Objective To investigate the predictive values of urinary retinol-binding protein （RBP）, liver fatty acid binding protein （L-FABP） and serum soluble CD14 subtype （Presepsin） levels for acute kidney injury （AKI） in patients with craniocerebral trauma after craniotomy. Methods A total of 279 patients with craniocerebral trauma who underwent craniotomy for hematoma evacuation were enrolled and divided into the non-AKI group （n = 193） and AKI group （n = 86） according to whether they were complicated with AKI. According to the AKI staging criteria proposed by Acute Kidney Injury Network （AKIN）, patients in the AKI group were further divided into stage Ⅰ （n = 27）, stage Ⅱ （n = 37） and stage Ⅲ groups （n = 22）.The urinary RBP, L-FABP and serum Presepsin levels at postoperative 2-4 h were statistically compared among different groups. The predictive value of each parameter for AKI was assessed by the receiver operating characteristic （ROC） curve. Results In the AKI group, urinary RBP, L-FABP and serum Presepsin levels were significantly higher than those in the non-AKI group （all P < 0.05）. The levels of three parameters were significantly increased over the AKI staging （all P < 0.05）. The areas under the curve （AUC） predicted by RBP, L-FABP and Presepsin were 0.946, 0.990 and 0.965, respectively. The sensitivity and specificity of RBP were 88.4% and 88.6%, 98.8% and 92.2% for L-FABP, 91.9% and 89.1% for Presepsin, respectively. The prediction accuracy of L-FABP was considerably higher than those of RBP and Presepsin （both P < 0.05）. Conclusion The urinary RBP, L-FABP and serum Presepsin level in patients with craniocerebral trauma can early predict the incidence of AKI and evaluate the severity of AKI after craniotomy for hematoma evacuation.