To explore the predictive value of urinary liver type fatty acid binding proteins (L-FABP) and serum heat shock proteins (Hsp72) on acute kidney injury (AKI) and prognosis in children with sepsis. Methods: Totally 216 children with sepsis treated in the pediatric intensive care unit (PICU) of Dujiangyan Maternal and Child Health Hospital from Jun. 2018 to Apr. 2021 were extracted to be divided into the AKI group (n = 80) and non-AKI group (n = 136) according to the occurrence of AKI. According to the staging standard of AKI

AKI group was further divided into the AKI-1 group (n = 28)

AKI-2 group (n = 23) and AKI-3 group (n = 29). According to the 28 d survival

the children were divided into the survival group (n = 165) and death group (n = 51). The levels of urinary L-FABP and serum Hsp72 among different groups were compared. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of urinary L-FABP and serum Hsp72 levels for secondary AKI and prognosis in children with sepsis. Univariate Logistic regression was used to analyze the correlation between the elevated levels of urinary L-FABP and serum Hsp72 and the risk of secondary AKI and death in children with sepsis. Results: The levels of urinary L-FABP and serum Hsp72 in AKI group were higher than those in non-AKI group (P<0. 05). The levels of urinary L-FABP and serum Hsp72 in AKI-3 group > AKI-2 group > AKI-1 group > non-AKI group

the differences were statistically significant (P<0. 05). The levels of urinary L-FABP and serum Hsp72 in the death group were higher than those in the survival group (P<0. 05). ROC curve showed that area under the curve (AUC) of urinary L-FABP

serum Hsp72 and urinary L-FABP + serum Hsp72 in predicting secondary AKI in children with sepsis were 0. 893

0. 823 and 0. 920. The AUC of urinary L-FABP + serum Hsp72 was higher than that of serum urinary L-FABP and serum Hsp72 ( Z was respectively 5. 819

4. 972

P< 0. 05). The sensitivity and specificity were 89. 4% and 80. 6% respectively. The AUC of urinary LFABP

serum Hsp72 and urinary L-FABP + serum Hsp72 in predicting the prognosis of children with sepsis were 0. 786

0. 817 and 0. 902. The AUC of urinary L-FABP + serum Hsp72 was higher than that of urinary L-FABP and serum Hsp72 (Z was respectively 4. 763

3. 796

P<0. 05). The sensitivity and specificity were 89. 6% and 80. 9% respectively. Univariate Logistic regression analysis showed that the elevated levels of urinary L-FABP and serum Hsp72 were significantly correlated with the risk of secondary AKI and death in children with sepsis (P<0. 05). Conclusion: Urinary L-FABP and serum Hsp72 are effective indicators to predict secondaryAKI and prognosis in children with sepsis. The combination of the two indicators is helpful to improve the efficiency of AKI diagnosis andprognosis evaluation.