Table 5.
Discrimination for Day3-AKI by the RAI in combination with urinary biomarkers
| Terms | Sensitivity | Specificity | PPV | NPV | +LR | ORa (95% CI) | AUC-ROC (95% CI) | AIC | NRI (P-value) | IDI (P-value) |
|---|---|---|---|---|---|---|---|---|---|---|
| Day0 RAI | 80 (52–97) | 72 (64–78) | 20 (11–32) | 98 (93–100) | 2.8 (2.0–4.0) | n/a | 0.80 (0.58, 1.00) | 48.8 | n/a | n/a |
| Day0 RAI+ NGAL | 86 (42–99) | 85 (77–90) | 23 (9–44) | 99 (95–100) | 5.6 (3.4–9.2) | NCb | 0.97 (0.93, 1.00) | 28.5 | 1.64 (<0.001) | 0.42 (0.02) |
| Day0 RAI+ KIM-1 | 43 (10–82) | 95 (90–98) | 33 (8–70) | 97 (92–99) | 9.3 (2.9–30) | 5.1 (0.5, 50.4) | 0.77 (0.53, 1.00) | 48.8 | 0.69 (0.007) | 0.039 (0.12) |
| Day0 RAI+ L-FABPc | 86 (57–98) | 56 (58–64) | 15 (8–25) | 98 (92–100) | 1.9 (1.5–2.6) | 2.5 (0.2, 43.2) | 0.82 (0.69, 0.95) | 82.0 | 0.49 (0.04) | 0.04 (0.31) |
| Day0 RAI+ IL-18c | 57 (29–82) | 97 (92–99) | 62 (32–86) | 96 (91–99) | 17.4 (6.6–46) | 5.5 (0.6, 47.1) | 0.79 (0.65, 0.92) | 81.1 | 0.87 (0.001) | 0.05 (0.05) |
Predictive performance and discrimination was determined for the primary outcome: severe AKI diagnosed by KDIGO Stage 2–3 change of creatinine from baseline. Sensitivity, specificity, PPV, NPV, positive likelihood ratio (+LR), AUC-ROC, change in AIC, NRI and IDI were performed on the RAI on Day0 of admission to the PICU. Effect of including urinary biomarkers NGAL, KIM-1, L-FABP and IL-18 measured on Day1 of PICU admission was then determined. Cutoff values used for the biomarkers were determined based on optimal Youden's index results on individual urinary biomarkers for the population tested (in ng/mL): NGAL >150, KIM-1 >4000, l-FABP >150 and IL-18 >1000. Patients included in this analysis: n = 137. Results expressed with 95% CI. n/a, not available.
aOdds ratio—analysis done for impact of biomarkers in renal angina positive patients.
bNot calculable.
c167.