Value of urine soluble triggering receptor expressed on myeloid cells-1 in the early diagnosis of sepsis associated acute kidney injury
10.3760/cma.j.issn.0578-1310.2018.05.007
- VernacularTitle: 尿可溶性髓样细胞触发受体1在脓毒症相关性急性肾损伤中的早期诊断价值
- Author:
Zhukang YUAN
1
,
2
,
3
,
4
;
Fang FANG
;
Chengjun LIU
;
Jing LI
;
Yingfu CHEN
;
Feng XU
Author Information
1. Department of Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University
2. Ministry of Education Key Laboratory of Child Development and Disorders
3. China International Science and Technology Cooperation Base of Child Development and Critical Disorders
4. Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
- Publication Type:Journal Article
- Keywords:
Sepsis;
Acute kidney injury;
Child
- From:
Chinese Journal of Pediatrics
2018;56(5):342-346
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the value of urine soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in early diagnosis and prognosis of sepsis associated acute kidney injury (AKI).
Methods:This was a case-control study. A total of 62 patients with sepsis during November 2016 to June 2017 were collected, who were divided into non-AKI sepsis (n= 49) and AKI sepsis (n=13) groups according to the serum creatinine (SCr) or urine output, sepsis with shock (n=22) and sepsis without shock (n=40) groups according to the presence of shock, survival (n=47) and death (n=15) groups according to the mortality. Twenty healthy children were recruited in control group, whose urine sTREM-1 were used as reference value. Urine and blood specimens were detected on admission (within 12 h), at 24 h and 48 h after admission. Student's t-test and Mann-Whitney U test were used for statistical analysis.
Results:On admission, the level of urine sTREM-1 were significantly higher in sepsis patients than in healthy controls (96.8 (71.3, 105.8) vs. 68.6 (60.6, 71.1)ng/L, Z=4.708, P<0.05). Comparing of sTREM-1 in different groups showed that the levels were higher in AKI sepsis patients than in the non-AKI ones ((106±5) vs. (86±18) ng/L, t=6.670, P<0.05), higher in the sepsis with shock group than in sepsis without shock group ((98±11) vs. (86± 20) ng/L, t=3.059, P<0.05), and also higher in death group than in survival group ((101±12) vs. (87±18) ng/L, t=3.615, P<0.05). The area under the receiver operating characteristic (AUROC) of urine sTREM-1 in predicting sepsis associated AKI was 0.814 (95%CI: 0.708-0.920), which was higher than that in predicting shock, increased serum creatinine, hyperlipidemia or hyperbilirubinemia (0.530, 0.425, 0.429 and 0.443, respectively). The optimal sTREM-1 cut-off point for predicting sepsis associated kidney injury was 96.5 ng/L, with specificity and sensitivity of 100% and 57.1%. The odds ratio(OR) of urine sTREM-1 was 0.879 with a significance of 0.005 after adjusting shock, prognosis, serum creatinine, lactate and total bilirubin level, indicating that the urine sTREM-1 was an independent risk factor of sepsis associated AKI.
Conclusion:Urine sTREM-1 can be used as an early diagnostic biomarker for sepsis associated AKI, with advantage of noninvasiveness and convenience. Trial registration: Chinese Clinical Trial Registry, ChiCTR-DDD-17010743.
