脓毒症诱导的急性肾损伤中肽基精氨酸脱亚氨酶4及PADI4基因多态性的评估

Evaluation of peptidylarginine deiminase 4 and PADI4 polymorphisms in sepsis-induced acute kidney injury.

作者信息

Costa Nara Aline, Polegato Bertha Furlan, Pereira Amanda Gomes, Paiva Sérgio Alberto Rupp de, Gut Ana Lúcia, Balbi André Luís, Ponce Daniela, Zornoff Leonardo Antonio Mamede, Azevedo Paula Schmidt, Minicucci Marcos Ferreira

机构信息

Professora Adjunta da Faculdade de Nutrição da Universidade Federal de Goiás - UFG, Goiania, GO, Brasil.

Professor(a) Associado(a) da Faculdade de Medicina de Botucatu - Unesp, Botucatu, SP, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2020 Nov;66(11):1515-1520. doi: 10.1590/1806-9282.66.11.1515.

DOI:10.1590/1806-9282.66.11.1515

PMID:33295402

Abstract

BACKGROUND

The aim of this study is to evaluate the peptidylarginine deiminase 4 (PAD 4) concentration and PADI4 polymorphisms as predictors of acute kidney injury (AKI) development, the need for renal replacement therapy (RRT), and mortality in patients with septic shock.

METHODS

We included all individuals aged ≥ 18 years, with a diagnosis of septic shock at ICU admission. Blood samples were taken within the first 24 hours of the patient's admission to determine serum PAD4 concentration and its PADI4 polymorphism (rs11203367) and (rs874881). Patients were monitored during their ICU stay and the development of SAKI was evaluated. Among the patients in whom SAKI developed, mortality and the need for RRT were also evaluated.

RESULTS

There were 99 patients, 51.5% of whom developed SAKI and of these, 21.5% needed RRT and 80% died in the ICU. There was no difference between PAD4 concentration (p = 0.116) and its polymorphisms rs11203367 (p = 0.910) and rs874881 (p = 0.769) in patients in whom SAKI did or did not develop. However, PAD4 had a positive correlation with plasma urea concentration (r = 0.269 and p = 0.007) and creatinine (r = 0.284 and p = 0.004). The PAD4 concentration and PADI4 polymorphisms were also not associated with RRT and with mortality in patients with SAKI.

CONCLUSION

PAD4 concentration and its polymorphisms were not associated with SAKI development, the need for RRT, or mortality in patients with septic shock. However, PAD4 concentrations were associated with creatinine and urea levels in these patients.

摘要

背景

本研究旨在评估肽基精氨酸脱亚氨酶4（PAD 4）浓度及肽基精氨酸脱亚氨酶4（PADI4）基因多态性，作为脓毒性休克患者急性肾损伤（AKI）发生、肾脏替代治疗（RRT）需求及死亡率的预测指标。

方法

我们纳入了所有年龄≥18岁、在重症监护病房（ICU）入院时诊断为脓毒性休克的患者。在患者入院后的头24小时内采集血样，以测定血清PAD4浓度及其PADI4基因多态性（rs11203367）和（rs874881）。在患者入住ICU期间进行监测，并评估脓毒症相关性急性肾损伤（SAKI）的发生情况。在发生SAKI的患者中，还评估了死亡率和RRT需求。

结果

共有99例患者，其中51.5%发生了SAKI，其中21.5%需要RRT，80%在ICU死亡。发生或未发生SAKI的患者之间，PAD4浓度（p = 0.116）及其基因多态性rs11203367（p = 0.910）和rs874881（p = 0.769）无差异。然而，PAD4与血浆尿素浓度（r = 0.269，p = 0.007）和肌酐（r = 0.284，p = 0.004）呈正相关。PAD4浓度和PADI4基因多态性也与SAKI患者的RRT需求和死亡率无关。