Aim: This study aims to explore the evaluation of lactic acid (Lac) and neutrophil gelatinase-associated lipocalin (NGAL) on the condition and prognosis of patients with diquat (DQ) poisoning.
Methods: A total of 79 cases of DQ poisoning treated in one hospital from January 2019 through February 2023 were included: 10 cases of mild poisoning, 49 cases of moderate to severe poisoning, and 20 cases of fulminant poisoning. According to the Kidney Disease: Improving Global Outcomes-acute kidney injury (KDIGO-AKI) criteria, the patients were divided into 60 cases in the AKI group and 19 cases in the non-acute kidney injury (NAKI) group. According to the AKI diagnostic indicators, AKI patients were divided into Grade I, Grade II, and Grade III. According to prognosis, the patients were divided into survivor group and non-survivor group. During the same period, 30 healthy subjects were selected as the healthy group. The changes of blood Lac, NGAL, cystatin C (CysC), and serum creatinine (Scr) levels of patients were detected, the 28-day survival of patients was recorded, and the correlation between blood Lac, NGAL levels, and renal injury grade in patients with AKI caused by DQ poisoning was analyzed. The receiver operator characteristic (ROC) curve was used to evaluate the predictive value and prognostic value of Lac, NGAL, and their combination in patients with AKI caused by DQ poisoning.
Results: There were significant differences in AKI grade, Lac, NGAL, CysC, and Scr levels among different degrees of poisoning groups (P < .05). There were significant differences in the levels of Lac, NGAL, CysC, and Scr among patients with different AKI grades (P < .05). The levels of Lac, NGAL, CysC, and Scr in the survivor group were significantly lower than those in the non-survivor group (P < .05). The blood Lac and NGAL levels were positively correlated with AKI grades in patients with DQ poisoning (r = 0.752, 0.836; P = .000, .000). The combined detection of blood Lac and NGAL had higher predictive value for AKI and assessed value for death in DQ poisoning than either of them alone.
Conclusion: The combined detection of Lac and NGAL have a certain clinical value in AKI grading and evaluating AKI prognosis caused by DQ poisoning.
Keywords: acute kidney injury; cystatin C; diquat poisoning; lactic acid; neutrophil gelatinase-associated lipocalin.