黄芪注射液对慢性肾脏病疗效和血管内皮生长因子及其可溶性受体的影响

目的:观察黄芪注射液对慢性肾脏病疗效和血管内皮生长因子及其可溶性受体的影响。方法:将80例慢性肾脏病分成治疗组和对照组,两组均采用一般基础治疗,治疗组加用黄芪注射液,静脉滴注2周,2周后观察临床疗效、中医症状积分和血压、血糖、血脂、肾功能、24 h尿蛋白定量、VEGF、s Flt-1等指标。结果:治疗组总有效率87.8%,对照组总有效率64.1%,两组差异有统计学意义(P0.05);治疗组临床症状改善明显优于对照组,特别是神疲乏力、腰膝酸软方面;两组治疗后血压、血糖、血脂、肾功能、24 h尿蛋白定量均有下降(P0.05),治疗组治疗后血肌酐、血胱抑素C、24 h尿蛋白定量较对照组治疗后差异有统计学意义(P0.05);治疗组较对照组可明显降低血清VEGF水平,升高血清s Flt1(P0.05)。结论:黄芪注射液可通过降低血清VEGF,升高血清s Flt1,减少慢性肾脏病患者蛋白尿,降低血肌酐,改善临床症状。     

血清胱抑素C联合尿微量蛋白检测在糖尿病肾损伤的早期诊断价值

目的探讨术前联合检测血清胱抑素C和尿微量蛋白对糖尿病患者肾损伤的早期诊断价值。方法选取48例拟接受手术治疗的糖尿病患者为观察组,选取同期48例在体检中心进行体检的健康人群为对照组。均采用散射免疫比浊乳胶增强法检测胱抑素C、尿微量白蛋白及β2微球蛋白,并对2组检测结果进行比较。结果观察组患者的血清胱抑素C、尿微量蛋白及β2微球蛋白均显著高于对照组,差异有统计学意义(P0.05)。结论术前联合检测血清胱抑素C和尿微量蛋白,对于糖尿病患者肾损伤的早期诊断及围手术期处理具有重要的临床价值。     

血胱抑素C、尿肾损伤分子-1水平和血清肌酐在急性肾损伤患者肾功能评估中的比较研究

目的:探讨肾功能状态标志物血胱抑素C、尿肾损伤分子-1水平相较于血清肌酐在评估急性肾损伤中的价值。方法:本研究以2014年2月~2015年6月我院收治的49例急性肾损伤患者以及40例健康体检者为研究对象,采用生化仪测定血胱抑素C以及血清肌酐的浓度变化、双抗体夹心酶标免疫分析法测定尿肾损伤分子-1水平;分析血胱抑素C、尿肾损伤分子-1水平相较于血清肌酐在急性肾损伤患者肾功能状态评估中的价值。结果:在急性肾损伤患者肾功能状态评估中血胱抑素C以及尿肾损伤分子-1的准确性、阳性以及阴性预测值显著高于血清肌酐(P0.05),其余指标不存在统计学差异(P0.05);全部患者以及Ⅰ期患者的血胱抑素C与尿肾损伤分子-1的检测灵敏度要优于血清肌酐(P0.05),而Ⅱ期及Ⅲ期患者无显著差别(P0.05)。结论:血胱抑素C、尿肾损伤分子-1水平均可作为评估急性肾损伤患者肾功能状态的内源性标志物,有助于尽早识别急性肾损伤患者肾功能的损害。     

黄芪三七合剂对原发性肾病综合征临床疗效观察

目的:探讨黄芪三七合剂对原发性肾病综合征的疗效。方法:将60例患者随机分为治疗组和对照组。治疗组在一般治疗、对症治疗、免疫抑制剂治疗的基础上同时给予黄芪三七合剂治疗;对照组则只给予一般治疗、对症治疗、免疫抑制剂等治疗。检测各组血清白蛋白(sAlb)、24h尿蛋白定量(24hup)、血清总胆固醇(TC)、三酰甘油(TG)、血清肌酐(Scr)、凝血指标、免疫指标IgA、IgG、IgM、C3、C4统计各组感染情况。结果:治疗3个月后,治疗组的尿蛋白及血脂水平显著下降,血清白蛋白水平和免疫球蛋白IgG显著升高,凝血指标明显好转,与对照组相比差异有统计学意义(P<0.05),治疗组感染次数明显少于对照组,差异有统计学意义(P<0.05)。结论:黄芪当归合剂能有效提高血清白蛋白水平,降低尿蛋白及血脂,改善高凝血症、调节免疫状态。     

海昆肾喜胶囊对慢性肾脏病患者血清胱抑素C的影响

目的 观察海昆肾喜胶囊对慢性肾脏病患者血清胱抑素C的影响.方法 20例明确诊断慢性肾脏病患者,在基础治疗上给予海昆肾喜胶囊每天6粒口服,于治疗前和治疗后8周分别检测血清胱抑素C、尿素氮、肌酐的变化.结果 海昆肾喜胶囊可明显降低慢性肾脏病患者的血清胱抑素C水平(P < 0.05);治疗前、后血清胱抑素C、血肌酐比较差异具有统计学意义(P < 0.05).结论 海昆肾喜胶囊可改善早期慢性肾脏病患者的肾功能,早期应用海昆肾喜胶囊有利于延缓慢性肾脏病的进展,具有一定临床意义.     

海昆肾喜胶囊对慢性肾脏病患者血清胱抑素C的影响

目的 观察海昆肾喜胶囊对慢性肾脏病患者血清胱抑素C的影响.方法 20例明确诊断慢性肾脏病患者,在基础治疗上给予海昆肾喜胶囊每天6粒口服,于治疗前和治疗后8周分别检测血清胱抑素C、尿素氮、肌酐的变化.结果 海昆肾喜胶囊可明显降低慢性肾脏病患者的血清胱抑素C水平(P < 0.05);治疗前、后血清胱抑素C、血肌酐比较差异具有统计学意义(P < 0.05).结论 海昆肾喜胶囊可改善早期慢性肾脏病患者的肾功能,早期应用海昆肾喜胶囊有利于延缓慢性肾脏病的进展,具有一定临床意义.     

海昆肾喜胶囊对慢性肾脏病患者血清胱抑素C的影响

目的 观察海昆肾喜胶囊对慢性肾脏病患者血清胱抑素C的影响.方法 20例明确诊断慢性肾脏病患者,在基础治疗上给予海昆肾喜胶囊每天6粒口服,于治疗前和治疗后8周分别检测血清胱抑素C、尿素氮、肌酐的变化.结果 海昆肾喜胶囊可明显降低慢性肾脏病患者的血清胱抑素C水平(P < 0.05);治疗前、后血清胱抑素C、血肌酐比较差异具有统计学意义(P < 0.05).结论 海昆肾喜胶囊可改善早期慢性肾脏病患者的肾功能,早期应用海昆肾喜胶囊有利于延缓慢性肾脏病的进展,具有一定临床意义.     

联合检测血清胱抑素C、同型半胱氨酸和尿微量白蛋白对早期糖尿病肾病的诊断价值

目的:探讨联合检测血清胱抑素C、同型半胱氨酸和尿微量白蛋白对早期糖尿病肾病的诊断价值。方法:分别检测56例糖尿病肾病患者、120例无肾病的糖尿病患者和60例健康体检者的血清胱抑素C、同型半胱氨酸和晨尿中的微量白蛋白含量,分析比较三者单项、两两联合及三项指标联合检测对早期糖尿病肾损伤的检验效能。结果:糖尿病患者HCY、Cys C、U-m Alb的水平明显高于正常对照组(P0.01),尿蛋白阳性组较尿蛋白阴性组升高明显(P0.01),三项指标联合检测发现糖尿病早期肾损伤的阳性率高达88.33%,明显高于单项检测及两两联合检测。结论:三项指标联合检测大大提高检测的灵敏度。对早期糖尿病肾病的发现以及后期病情发展的监测有重要意义。     

胱抑素C对评价慢性肾脏病患者代谢指标的应用价值

目的 研究胱抑素C对慢性肾脏病患者代谢指标及心脏疾病患病率的评价作用.方法 制作慢性肾脏病患者估算肾小球滤过率、血清肌酐、胱抑素C分别与血红蛋白、血钾、碳酸氢根、血磷散点图,并行直线回归相关分析.使用完全随机设计的单因素ANOVA分析胱抑素C与慢性肾脏病患者心脏疾病关系.结果 胱抑素C在评价慢性肾脏病患者贫血程度、高钾血症、高磷血症中的作用优于估算肾小球滤过率及血清肌酐.胱抑素C及血清肌酐在评价慢性肾脏病患者代谢性酸中毒的作用优于估算肾小球滤过率.胱抑素C水平高低与慢性肾脏病患者的心脏疾病的患病率成正相关(P＜0.05).结论 通过估算肾小球滤过率和血清肌酐,胱抑素C在评价慢性肾脏病患者代谢指标方面及评估患者心脏疾病患病率方面存在优势.     

替米沙坦联合黄芪注射液治疗早期糖尿病肾病的临床观察

目的：探讨替米沙坦联合黄芪注射液治疗早期糖尿病肾病的临床疗效。方法：76例早期糖尿病肾病患者随机分为对照组和治疗组各38例，治疗组在糖尿病治疗的基础上加用替米沙坦、黄芪注射液，对照组在基础治疗上加用替米沙坦，疗程2周，观察治疗前后尿白蛋白排泄率（ UAER）变化。结果：替米沙坦联合黄芪注射液治疗早期糖尿病肾病能有效降低尿蛋白，与对照组治疗后比较，尿白蛋白排泄率（ UAER）较治疗前有明显改善，且治疗组改善情况优于对照组，组间比较差异有统计学意义（P〈0.05）。两组患者血肌酐和尿素氮治疗后有所降低，且治疗组较对照组稍低，但组间比较差异无统计学意义（P〉0.05）。结论：替米沙坦联合黄芪注射液治疗早期糖尿病肾病可有效降低尿蛋白，具有较好的安全性和耐受性。     

黄芪、厄贝沙坦对糖尿病肾脏病肝细胞生长因子表达的影响

目的观察黄芪、厄贝沙坦治疗前后糖尿病。肾脏病（DKD）早期患者血清肝细胞生长因子（HGF）表达的变化。方法120例DKD早期患者,随机分为对照组（A组）、黄芪治疗组（B组）、厄贝沙坦治疗组（C组）、黄芪联合厄贝沙坦治疗组（D组）,每组30例。比较各组治疗前后血清HGF水平以及尿微量白蛋白（MA）、血糖、胰岛素、血脂等指标。结果B、C、D组血清HGF表达水平较A组明显升高,尿MA较A组减少,血总胆固醇（TC）、低密度脂蛋白胆固醇（LDDC）水平下降,D组治疗效果尤为显著。结论黄芪、厄贝沙坦及二者联合治疗均上调DKD早期患者血清HGF水平,同时可减轻尿MA,降低血肌酐（SQ）水平,降低TC及LDL-C。血清HGF是肾脏的重要保护因子,对防治DKD有重要意义。     

黄芪注射液对儿童肾病综合征尿蛋白与血浆蛋白的影响

目的 :观察黄芪注射液对儿童肾病综合征尿蛋白与血浆蛋白的影响。方法 :将我科 1996年 10月～2 0 0 2年 10月收治的小儿肾病综合征 30例 ,随机分为 2组。治疗组 17例 ,采用强的松加黄芪注射液治疗 ;对照组 13例仅给强的松治疗。结果 :治疗 1个月后 ,治疗组临床症状及血液生化指标等明显优于对照组 ,2 4h尿蛋白降低与血浆白蛋白升高与对照组比较 ,差异有统计学意义 (P <0 .0 1)。结论 :黄芪注射液对儿童肾病综合征有明显疗效 ,尤其在减轻蛋白尿 ,提高血浆蛋白方面 ,值得临床应用     

肾糖颗粒对糖尿病肾病大鼠C-Ⅳ与FN表达的影响

目的：观察肾糖颗粒对糖尿病肾病大鼠Ⅳ型胶原蛋白（C-Ⅳ）、纤维连接蛋白（FN）表达的影响,进而探讨肾糖颗粒在糖尿病肾病大鼠肾保护中的作用机制。方法：采用高脂饲料喂养＋STZ腹腔注射制作糖尿病肾病大鼠模型。分为正常对照组、模型对照组、中药治疗组（肾糖颗粒组）、西药治疗组（洛汀新组）、中西药治疗组（肾糖颗粒＋洛汀新组）,测定大鼠24 h尿蛋白定量、尿视黄醇结合蛋白、尿微量白蛋白,免疫组化方法测定大鼠的C-Ⅳ、FN表达。结果：经肾糖颗粒治疗8周后,24 h尿蛋白定量、尿视黄醇结合蛋白、尿微量白蛋白各治疗组均明显低于模型组（P〈0.05）;大鼠模型组的C-Ⅳ、FN分别呈现高阳性表达,明显高于各治疗组（P〈0.05）。结论：肾糖颗粒对糖尿病肾病大鼠有一定的治疗效果,可以改善肾功能,延缓糖尿病的肾脏损伤,其可能机制是抑制了大鼠的肾纤维化的进展,与抑制了C-Ⅳ、FN在大鼠肾组织中的表达有关。     

肾安冲剂对阿霉素肾病大鼠的治疗作用

目的：观察肾安冲剂对阿霉素肾病大鼠的治疗作用。方法：SD大鼠尾静脉注射阿霉素建立肾病综合征模型。雄性SD大鼠72只,随机分为6组：正常对照组、模型组、肾安冲剂小剂量组、肾安冲剂中剂量组、肾安冲剂大剂量组和泼尼松组,每组12只。连续给药8周,观察肾安冲剂对阿霉素肾病大鼠的24h尿蛋白、血清白蛋白、血清胆固醇、三酰甘油及肾组织病理形态学等方面的影响。结果：（1）与正常组比较,模型组24h尿蛋白定量、血脂水平明显升高,血清白蛋白水平明显降低（均P〈0.01）;（2）与模型组比较,各治疗组大鼠24h尿蛋白定量、血脂水平明显降低,血清白蛋白水平明显升高（均P〈0.01）;（3）肾安冲剂治疗组各指标与泼尼松组比较均有统计学差异（均P〈0.01）,说明肾安冲剂疗效优于泼尼松。结论：肾安冲剂具有降低尿蛋白、升高血清白蛋白水平,降低血脂以及减轻肾脏损害的作用。     

中西医结合治疗原发性肾病综合征的临床研究

目的 :探讨中西医结合治疗原发性肾病综合征 (PNS)临床意义。方法 :2 6 6例PNS患者随机分为治疗组 (中药 强的松 )和对照组 (强的松 ) ,观察两组治疗前后的临床表现 ,2 4h尿蛋白定量、血浆白蛋白、血脂、肾功能及尿纤维蛋白降解产物 (FDP) ,副作用和并发症及复发情况。结果 :治疗前两组各项生化指标 ,尿FDP均明显异常 ,治疗后治疗组各项生化指标及尿FDP明显改善 ,治疗前后比较 (P <0 .0 1或 <0 .0 5 )。治疗组总有效率 (97.2 % )高于对照组 (72 .2 % ) ,对照组副作用和并发症发生率 (5 9.5 % )高于治疗组 (2 1.8% ) ,治疗组复发率 (2 .8% )低于对照组(13.5 % )。结论 :中西医结合治疗具有调节PNS免疫紊乱的作用。能提高疗效 ,减少副作用和并发症。对预防感染 ,巩固疗效 ,减少复发有一定帮助。     

益肾调经方对阿霉素肾病伴雷公藤多苷致性腺抑制的雌性大鼠肾保护作用的实验研究

目的：在阿霉素尾静脉注射造成微小病变肾病动物模型的基础上，建立雷公藤多苷致雌性肾病大鼠性腺抑制的模型，并观察益肾调经方（YSTJF）对其的影响，探讨YSTJF对阿霉素肾病伴性腺抑制的雌性大鼠肾保护作用。方法：雌性SD大鼠50只，随机挑选6只作正常对照组。余用阿霉素5mg／kg一次性尾静脉注射造成微小病变肾病动物模型，并随机分为6组：（1）肾病模型组：再予蒸馏水灌胃。（2）性腺抑制组：再予雷公藤多苷80mg·kg^-1·d^-1。（3）YSTJF高、中、低剂量组：予雷公藤多苷80mg·kg^-1·d^-1、YSTJF水煎浓缩液（分别为含生药75、50、25g·kg^-1·d^-1）合用每日灌胃。（4）西药对照组：予雷公藤多苷片80mg·kg^-1·d^-1和结合雌激素倍美力0．02mg·kg^-1·d^-1叫合用每日灌胃。该实验共8周，实验结束后收集标本，24h尿蛋白、N-乙酰-β-D-氨基葡萄糖苷酶（NAG），血肌酐（Scr），尿素氮（BUN）；光镜下观察肾脏组织的病理。结果：肾病模型组的尿蛋白、尿NAG酶明显高于正常对照组；性腺抑制组、YSTJF各剂量组和西药对照组能降低尿蛋白、尿NAG酶；、YSTJF中低剂量组降低尿蛋白与性腺抑制组比较（P〈0．05）；、YSTJF高剂量组降低尿NAG酶优于低剂量组和性腺抑制组。肾病模型组BUN高于正常对照组（P〈0．05）；性腺抑制组、、YSTJF各剂量组和西药对照组均低于肾病模型组（P〈0．05）；YSTJF各剂量组、西药对照组比性腺抑制组降低更明显（P〈0．05），YSTJF各剂量组比西药对照组为佳（P〈0．05）。从肾脏病理改变的小管间质病变积分分析：YSTJF各剂量组积分低于肾病模型组、性腺抑制组（P〈0．05），高、中剂量组较西药对照组为佳。结论：YSTJF可以通过降低尿蛋白、NAG酶、BUN，降低肾小管间质积分，改善肾小管间质病理改变，对于阿霉素肾病伴性腺抑制的雌性大     

Study of lead exposure from automobile exhaust as a risk for nephrotoxicity among traffic policemen

BACKGROUND: Traffic policemen are the most exposed population to lead (Pb) from automobile exhaust. There has been increasing concern about the possible harmful effects of Pb from automobile exhaust on health of traffic policemen. However, no such study was concerned with the impact of Pb exposure on renal function among them. Therefore, we aimed to study the effect of Pb exposure from automobile exhaust on renal integrity among traffic policemen. METHODS: Markers of tubular damage [urinary excretion of beta(2)-microglobulin (beta(2)M), N-acetyl-beta-D-glucosaminidase (NAG), alkaline phosphatase (ALP) and gamma-glutamyl transferase (gamma-GT)], a marker of glomerular injury (albuminuria), and markers of glomerular filtration [serum creatinine, serum beta(2)M and blood urea nitrogen (BUN)] were determined in 43 traffic policemen (Pb-exposed group) and 52 matched healthy persons (control group). Pb levels in blood, urine, hair and nails were determined in the two groups as exposure indices of Pb. RESULTS: The results obtained show that the Pb-exposed group had higher Pb levels in blood, urine, hair and nails than the controls. Among the Pb-exposed group, Pb levels in blood, hair and nails showed significant and positive correlations with the duration of exposure to Pb which is measured as the duration of employment. Among the studied markers of kidney damage, urinary excretion of NAG and albumin were significantly higher in the Pb-exposed group than in the controls. Urinary excretion of NAG was positively correlated with duration of exposure, blood Pb and nail Pb. Urinary albumin was positively correlated with duration of exposure, blood Pb and hair Pb. The other markers of kidney damage were neither elevated nor correlated with exposure indices of Pb. CONCLUSION: Traffic policemen are liable to Pb toxicity, and the determination of Pb in blood, hair and nails are good markers of such toxicity. In these exposure conditions, kidney damage is possible. Such damage is both tubular and glomerular in nature and can be documented by determination of the urinary excretion of NAG and albumin.     

Clinical characteristics of normotensive renal transplant recipients with microalbuminuria and effects of angiotensin II type I receptor antagonist on urinary albumin excretion

AIM: Microalbuminuria is typically observed in renal transplant recipients with systemic hypertension. The effects of angiotensin II type 1 receptor antagonist (losartan) on the hypertensive recipients have been evaluated. However, the clinical background of normotensive recipients with microalbuminuria and the effect of losartan administration in those subjects have not been clarified. One of the two purposes for the present study was to investigate the clinical characteristics of normotensive recipients with microalbuminuria. The other was to evaluate the effect of losartan on urinary excretion of albumin in these patients. METHODS: The clinical data and the change of the single kidney glomerular filtration rate (GFR) for the graft by radionuclide study were assessed in 13 normotensive recipients with microalbuminuria. These were compared with the data of 13 normotensive patients without microalbuminuria. The 13 recipients with microalbuminuria were treated with losartan for one year and urine excretion of albumin, N-acetyl-beta-D-glucosaminidase (NAG) and serum creatinine (S-Cr) levels were measured. RESULTS: The GFR of the grafts from donors to recipients significantly increased (30.9 to 55.2 mL/min) in microalbuminuric recipients, but did not significantly increase in the non-microalbuminuric recipients. Decreases of the urinary excretion rate of albumin (351 +/- 261 at baseline to 158 +/- 14 mg/gCr at 12 months), NAG (13 +/- 5 to 10 +/- 3 IU/gCr) and S-Cr (1.7 +/- 0.6 to 1.5 +/- 0.4 mg/DL) were observed in the microalbuminuric recipients with losartan administration. CONCLUSIONS: The present study suggests that an increased single kidney GFR of the graft from the donor in situ to the recipient might be a cause of microalbuminuria in normotensive recipients. The one-year effects of losartan were observed in terms of the decrease in urinary excretion of albumin, NAG and S-Cr levels.     

Early evaluation of renal reperfusion injury after prolonged cold storage using proton nuclear magnetic resonance spectroscopy

BACKGROUND: Proton nuclear magnetic resonance (NMR) spectroscopy can be used as a non-invasive tool to measure renal damage. In the present investigation, proton NMR spectroscopy of urine was assessed in order to detect cellular damage after different periods of cold ischaemia in two standard preservation solutions. METHODS: The isolated perfused pig kidney was used to assess initial renal function after in situ cold flush and cold storage (CS) for 24 or 48 h in two standard preservation solutions: EuroCollins (EC) and University of Wisconsin (UW) solutions. Kidneys flushed with cold heparinized saline and immediately perfused were used as a control group. Kidneys were perfused for 2 h at 37.5 degrees C for functional evaluation. During reperfusion, renal perfusion flow rate was measured. Glomerular filtration rate (GFR), tubular reabsorption of sodium ions, and lactate dehydrogenase (LDH) and N-acetyl-beta-D-glucosaminidase (NAG) excretion were determined. Impairment caused by ischaemia and reperfusion was also determined by histological techniques and proton NMR spectroscopy. RESULTS: The perfusion flow rate, GFR and tubular reabsorption of sodium were significantly decreased in experimental groups compared with the control group. There was no significant difference between experimental groups after 24 h of CS. The perfusion flow rate was significantly decreased in the EC group after 48 h of cold ischaemia compared with that in the UW group. After 48 h of CS, GFR and tubular reabsorption of sodium were significantly reduced in the EC group compared with those in the UW group. The release of LDH into the effluent and the urinary excretion of NAG were not significantly different after 24 h of CS. After more than 45 and 60 min of reperfusion respectively, LDH and NAG excretion was no different in the 48-h CS groups. The most relevant resonances determined by proton NMR spectroscopy were of citrate, trimethylamine-N-oxide, lactate, acetate and amino acids. Excretion of these markers was significantly more accurate and efficient to assess renal ischaemia-reperfusion injury than that of biochemical markers. A resonance (P) detected particularly in the EC group after 48 h of CS was identified and correlated well with renal dysfunction. After CS for 48 h and 2 h of reperfusion, renal injury was histologically more pronounced in EC groups than in UW groups. However, the difference was not significant after CS for 24 h. CONCLUSION: NMR spectroscopy, which is a non-invasive and non-destructive technique, is more accurate and efficient when assessing kidney damage after cold ischaemia and reperfusion when compared to conventional histological and biochemical analysis.     

Urinary biomarkers in the early diagnosis of acute kidney injury

A change in the serum creatinine is not sensitive for an early diagnosis of acute kidney injury. We evaluated urinary levels of matrix metalloproteinase-9 (MMP-9), N-acetyl-beta-D-glucosaminidase (NAG), and kidney injury molecule-1 (KIM-1) as biomarkers for the detection of acute kidney injury. Urine samples were collected from 44 patients with various acute and chronic kidney diseases, and from 30 normal subjects in a cross-sectional study. A case-control study of children undergoing cardio-pulmonary bypass surgery included urine specimens from each of 20 patients without and with acute kidney injury. Injury was defined as a greater than 50% increase in the serum creatinine within the first 48 h after surgery. The biomarkers were normalized to the urinary creatinine concentration at 12, 24, and 36 h after surgery with the areas under the receiver-operating characteristic curve compared for performance. In the cross-sectional study, the area under the curve for MMP-9 was least sensitive followed by KIM-1 and NAG. Combining all three biomarkers achieved a perfect score diagnosing acute kidney injury. In the case-control study, KIM-1 was better than NAG at all time points, but combining both was no better than KIM-1 alone. Urinary MMP-9 was not a sensitive marker in the case-control study. Our results suggest that urinary biomarkers allow diagnosis of acute kidney injury earlier than a rise in serum creatinine.