尿沉渣评分对急性肾损伤诊断的临床应用研究OA

Objective To validate the discriminative value of urinary sediment score(USS)in differentiating prerenal acute kidney injury(AKI)from acute tubular necrosis(ATN),and to evaluate the correlation between USS and AKI severity/prognosis,providing evidence for optimizing stratified AKI management.Methods A retrospective analysis was conducted on 120 AKI patients treated at Zhengzhou Traditional Chinese Medicine Hospital from March 2021 to February 2022.According to renal tissue biopsy and modified FENa-UA diagnostic criteria,patients were divided into a prerenal AKI group(n=68)and an ATN group(n=52).On the day of admission,USS,serum cystatin C(Cys-C),and urinary neutrophil gelatinase-associated lipocalin(NGAL)were measured to analyze the diagnostic performance of USS.Results USS was significantly higher in ATN group than prerenal group(P＜0.001),and increased with advancing AKI stages(P＜0.001).The area under the ROC curve(AUC)of USS for diagnosing prerenal AKI was 0.892,which improved to 0.941 when combined with Cys-C and NGAL,yielding sensitivity and specificity of 90.12%and 88.51%,respectively.Conclusions USS quantifies structural damage to the renal tubules,allowing for early differentiation between prerenal AKI and ATN.Its combined use with Cys-C and NGAL improves diagnostic accuracy and is of significant value in predicting AKI prognosis,providing an objective basis for clinical stratified management.