Department of Emergency Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2022 Jul 15;101(28):e29919. doi: 10.1097/MD.0000000000029919.
Acute kidney injury (AKI) is a common complication in patients with sepsis. We evaluated the potential prognostic value of plasma presepsin to predict AKI in patients with sepsis in the emergency department. A total of 193 patients diagnosed with sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were included in this observational study. AKI was defined according to the Kidney Disease Improving Global Outcomes clinical practice guideline. Plasma presepsin levels were measured on admission to the emergency department. We compared plasma presepsin levels between patients who did and those who did not develop AKI. AKI occurred in 100 (51.8%) patients. The median plasma presepsin level was significantly higher in patients with AKI than in those without AKI (1061 pg/mL vs 495 pg/mL, P <.001). Plasma presepsin levels were significantly increased in patients with AKI stage 3 compared with those with AKI stages 1 and 2 (P =.001). The area under the curve of presepsin for predicting AKI was 0.793 (95% confidence interval: 0.729-0.848). The optimal presepsin cutoff value for predicting AKI was >572 pg/mL, with a sensitivity of 77.0% and specificity of 81.7%. Plasma presepsin level is a valuable biomarker for the prediction of AKI in patients with sepsis in the emergency department.
急性肾损伤(AKI)是脓毒症患者的常见并发症。我们评估了血浆前降钙素原预测急诊脓毒症患者 AKI 的潜在预后价值。这项观察性研究共纳入了 193 名根据第三届国际脓毒症和脓毒性休克定义共识(Sepsis-3)诊断为脓毒症的患者。AKI 根据肾脏病改善全球结局临床实践指南定义。在急诊就诊时测量血浆前降钙素原水平。我们比较了发生和未发生 AKI 的患者的血浆前降钙素原水平。100 名(51.8%)患者发生 AKI。AKI 患者的血浆前降钙素原中位数明显高于无 AKI 患者(1061 pg/mL 比 495 pg/mL,P <.001)。与 AKI 1 期和 2 期患者相比,AKI 3 期患者的血浆前降钙素原水平显著升高(P =.001)。前降钙素原预测 AKI 的曲线下面积为 0.793(95%置信区间:0.729-0.848)。预测 AKI 的最佳前降钙素原截断值为 >572 pg/mL,其灵敏度为 77.0%,特异性为 81.7%。血浆前降钙素原水平是预测急诊脓毒症患者 AKI 的有价值的生物标志物。