[Value of urine soluble triggering receptor expressed on myeloid cells-1 in the early diagnosis of sepsis associated acute kidney injury].

UNLABELLED

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). 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 ( 49) and AKI sepsis (13) groups according to the serum creatinine (SCr) or urine output, sepsis with shock (22) and sepsis without shock (40) groups according to the presence of shock, survival (47) and death (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 -test and Mann-Whitney test were used for statistical analysis. On admission, the level of urine sTREM-1 were significantly higher in sepsis patients than in healthy controls (96.8 (71.3, 105.8) . 68.6 (60.6, 71.1)ng/L, 4.708, 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) . (86±18) ng/L, 6.670, 0.05), higher in the sepsis with shock group than in sepsis without shock group ((98±11) . (86± 20) ng/L, 3.059, 0.05), and also higher in death group than in survival group ((101±12) . (87±18) ng/L, 3.615, 0.05). The area under the receiver operating characteristic (AUROC) of urine sTREM-1 in predicting sepsis associated AKI was 0.814 (95%: 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() 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. 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.