Abstract: Objective  To explore the predictive value of coagulation markers combined with serum monocyte chemotaxis protein-1 (MCP-1)  for acute kidney injury(AKI)in patients with chronic kidney disease(CKD).  Methods   A total of 155 CKD patients were admitted to our hospital from January 2021 to June 2023, among which 40 patients had AKI. Clinical data, coagulation indices and serum MCP-1 were compared between the 40 patients with AKI and the 115 CKD patients without AKI. The important risk factors for the presence of AKI and the value of coagulation indices combined with serum MCP-1 for the prediction of AKI in CKD patients was explored.  Results   Thrombin time (TT), activated partial thrombin time (APTT), prothrombin time(PT)and serum MCP-1 were higher in AKI group than in non-AKI group (t=20.506,20.551,21.120 and 16.230 respectively; P＜0.001); fibrinogen(FIB)was lower in AKI group than in non-AKI group (t=8.441,P＜0.001). The presence of AKI was not related to age, sex, body mass index (BMI) and diabetes mellitus (t=0.521, 0.760, 0.648 and 2.399 respectively; P=0.477, 0.383, 0.341 and 0.121 respectively), but was related to diastolic blood pressure, systolic blood pressure, serum uric acid, fasting blood glucose, total cholesterol(TC),serum creatinine(Scr), triglyceride(TAG), hyperlipidemia and hypertension (t=15.681, 12.942, 11.694, 6.914, 12.836, 8.392, 9.724, 14.856 and 11.372 respectively; P＜0.001). Multivariate logistic regression using the presence of AKI as the dependent variable and the factors with P values＜0.05 described above as the independent variables demonstrated that systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood uric acid, TC, TAG, Scr, hypertension, hyperlipidemia, PT, TT, FIB, APTT and MCP-1 were the main risk factors for AKI in CKD patients (OR value=3490, 3.357, 3.050, 2.980, 3.264, 2.861, 3.287, 2.939, 3.466, 9.196, 3.350, 3.281, 2.974 and 3.404 respectively; 95% CI： 2.210～4.770, 1.947～4.767, 1.862～4.238, 1.838～4.122, 2.104～4.424, 1.751～3.971, 2.065～4.510, 1.813～4.065, 2.416～4.516, 1.982～4.410, 2.082～4.618, 2.103～4.459, 1.780～4.168 and 2.092～4.716 respectively; P=0.002, 0.004, 0.005, 0.002, ＜0.001, ＜0.001, ＜0.001, 0.007, 0.002, ＜0.001, ＜0.001, ＜0.001, ＜0.001 and ＜0.001 respectively).   Conclusion   The levels of TT, APTT, PT, FIB and MCP-1 are related to the occurrence of AKI,  and have the ability to predict the occurrence of AKI in CKD patients.

Key words: Coagulation index, Monocyte chemotactic protein-1, Chronic kidney disease, Acute kidney injury