Abstract: Objective To explore the predictive value of serum milk fat globule-EGF factor 8 protein (MFG-E8) and leucine rich alpha-2 glycoprotein 1 (LRG1) for acute kidney injury (AKI) in patients with severe pancreatitis.Methods A study was conducted on 100 patients with severe pancreatitis admitted to our hospital from January 2020 to August 2023.They were grouped into AKI group (43 cases) and non AKI group (57 cases) based on whether AKI occurred within 48 hours.Enzyme linked immunosorbent assay (ELISA) was applied to determine the levels of serum MFG-E8 and LRG1 in each group.Spearman correlation was applied to analyze the correlation between serum MFG-E8,LRG1 expression levels and Acute Physiological And Chronic Health Evaluation Ⅱ (APACHE Ⅱ).Logistic regression was applied to analyze the factors affecting AKI in patients with severe pancreatitis.Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum MFG-E8 and LRG1 for AKI in patients with severe pancreatitis.Results Compared with the non AKI group,the expression level of LRG1 in the AKI group was obviously increased (P＜0.05),while the expression level of MFG-E8 was significantly reduced (P＜0.05).There was a negative correlation between serum MFG-E8 level and APACHE Ⅱ score in severe pancreatic patients (r=-0.444,P＜0.05),while there was a positive correlation between serum LRG1 level and APACHE Ⅱ score (r=0.655,P＜0.05).The results of multivariate Logistic regression analysis showed that serum MFG-E8 was a protective factor for AKI in patients with severe pancreatitis (P＜0.05).LRG1,serum creatinine,and uric acid were all risk factors for AKI in patients with severe pancreatitis (P＜0.05).The combination of serum MFG-E8 and LRG1 in predicting AKI in patients with severe pancreatitis was superior to MFG-E8 and LRG1 alone in predicting AKI (Z_{combination - MFG-E8}=2.952,P=0.003;Z_{combination-LRG1}=2.385,P=0.017).Conclusion The serum MFG-E8 expression level is significantly reduced and LRG1 expression level is significantly increased in severe pancreatitis patients with AKI.The combination of the two can be used for predicting AKI in severe pancreatitis patients.

Key words: milk fat globule-EGF factor 8 protein; leucine rich alpha-2 glycoprotein 1; severe pancreatitis; acute kidney injury; prediction