Clinical value of soluble urokinase-type plasminogen activator receptor in predicting sepsis-associated acute kidney injury
Wenwen Zhang,
Yue Gu,
Jing Zhou,
Juntao Wang,
Xiaoru Zhao,
Xiaoyu Deng,
Han Li,
Lei Yan,
Xiaojing Jiao,
Fengmin Shao
Affiliations
Wenwen Zhang
Department of Nephrology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Yue Gu
Department of Nephrology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory for Kidney Disease and Immunology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Jing Zhou
Department of Nephrology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory for Kidney Disease and Immunology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Juntao Wang
Department of Nephrology, The First People’s Hospital of Shangqiu, Shangqiu, China
Xiaoru Zhao
Department of Nephrology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Xiaoyu Deng
Department of Nephrology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Han Li
Department of Nephrology, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Lei Yan
Department of Nephrology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory for Kidney Disease and Immunology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Xiaojing Jiao
Department of Nephrology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory for Kidney Disease and Immunology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Fengmin Shao
Department of Nephrology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory for Kidney Disease and Immunology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
Background Sepsis-associated acute kidney injury (S-AKI) is a critical illness and is often associated with high morbidity and mortality rates. The soluble urokinase-type plasminogen activator receptor (suPAR) is an important immune mediator and is involved in kidney injury. However, its diagnostic value in S-AKI patients remains unclear. Therefore, we assessed the early predictive value of suPAR for S-AKI patients.Methods We prospectively enrolled adult patients, immediately after fulfilling the sepsis-3 criteria. Plasma suPAR levels at 0-, 12-, 24-, and 48-h post-sepsis diagnosis were measured. S-AKI development was the primary outcome. S-AKI risk factors were analyzed using logistic regression, and the value of plasma suPAR for early S-AKI diagnosis was assessed using receiver operating characteristic (ROC) curves.Results Of 179 sepsis patients, 63 (35.2%) developed AKI during hospitalization. At 12-, 24-, and 48-h post-sepsis diagnosis, plasma suPAR levels were significantly higher in patients with S-AKI than in patients without S-AKI (p < 0.05). The plasma suPAR had the highest area under the ROC curve of 0.700 (95% confidence interval (CI), 0.621–0.779) at 24-h post-sepsis diagnosis, at which the best discrimination ability for S-AKI was achieved with suPAR of ≥6.31 ng/mL (sensitivity 61.9% and specificity 71.6%). Logistic regression analysis showed that suPAR at 24-h post-sepsis diagnosis remained an independent S-AKI risk factor after adjusting for mechanical ventilation, blood urea nitrogen, and pH.Conclusions The findings suggest that plasma suPAR may be a potential biomarker for early S-AKI diagnosis.
