Modern early diagnostic methods for acute kidney injury in wounded and injured patients

Background: This study substantiated the development of a mathematical model for predicting acute kidney injury (AKI) at the stage of qualified medical care and a diagnostic method for early detection of this complication in trauma-related disease using immunochromatographic test strips for cystatin C detection in single urine samples.

Materials and methods: The study involved two phases. In phase 1, upon hospital admission, the patients’ condition was assessed using a military field surgery scale for severity evaluation. A complete blood count and urinalysis were performed, as well as three sequential biochemical blood tests to determine standard AKI markers. Obtained data were used to develop a predictive formula for AKI. In phase 2, retrospectively, after preliminary sample preparation, an AKI diagnostic method was employed using the developed immunochromatographic test strips for cystatin C detection in a single urine sample.

Results: Upon applying a urine sample to the test strip, it interacts with a conjugate, and a control marker appears. If cystatin C binds to specific antibodies, two lines appear, indicating a positive test result. The method allows for the verification of AKI with > 80% accuracy in the early phase of trauma-related disease.

Conclusions: This study highlights the importance of a comprehensive approach that incorporates a predictive model on hospital admission of wounded patients. Implementing rapid diagnostic methods using cystatin C in the early stages of medical care improves triage efficiency, facilitates intensive therapy, and optimizes patient management during evacuation delays.