He Jian, Zheng Feng, Qiu Lihua, Wang Yilan, Zhang Jing, Ye Hongwei, Zhang Qian
Department of Intensive Care Unit, First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, Jiangsu, China.
Front Med (Lausanne). 2024 Nov 19;11:1496966. doi: 10.3389/fmed.2024.1496966. eCollection 2024.
There is currently no accurate, readily available, or validated biomarker for assessing disease severity and survival outcomes in sepsis-induced acute kidney injury (SAKI), which limits the ability to conduct effective therapeutic interventions. The neutrophil extracellular traps (NETs) may be involved in the pathophysiology of SAKI. The present study investigated the predictive value of plasma NETs for the survival outcome of patients with SAKI.
This observational study included 136 SAKI patients, all of whom underwent a 28-day follow-up. According to the follow-up records, SAKI patients were divided into two groups: the non-survivor group (60 subjects) and the survivor group (76 subjects). Blood samples were collected after the diagnosis of AKI to measure three NET markers and 12 inflammatory indices. Correlation analysis, logistic regression analysis, receiver operating characteristic curve analysis, and survival analysis were performed.
Compared to survivors, non-survivors among SAKI patients exhibited significantly higher levels of three plasma NET markers (all < 0.001). Meanwhile, in SAKI patients, plasma levels of NET markers were significantly associated with serum levels of inflammatory indices. Additionally, serum interleukin (IL)-2, IL-8, IL-10, and tumor necrosis factor-alpha showed an interactive effect with plasma NET markers on the survival of SAKI patients. Furthermore, the combination of three plasma NET markers could identify SAKI patients with a poor 28-day survival with better accuracy (area under the curve 0.857). Finally, plasma NET markers may independently predict the 28-day survival in SAKI patients.
Plasma NET markers were elevated in SAKI patients with poor outcomes and served as biomarkers for predicting 28-day survival in SAKI patients.
目前，在脓毒症诱导的急性肾损伤（SAKI）中，尚无准确、便捷或经过验证的生物标志物可用于评估疾病严重程度和生存结局，这限制了进行有效治疗干预的能力。中性粒细胞胞外陷阱（NETs）可能参与了SAKI的病理生理过程。本研究调查了血浆NETs对SAKI患者生存结局的预测价值。
这项观察性研究纳入了136例SAKI患者，所有患者均接受了为期28天的随访。根据随访记录，将SAKI患者分为两组：非存活组（60例）和存活组（76例）。在诊断为急性肾损伤后采集血样，以检测三种NET标志物和12种炎症指标。进行了相关性分析、逻辑回归分析、受试者工作特征曲线分析和生存分析。
与存活者相比，SAKI患者中的非存活者三种血浆NET标志物水平显著更高（均<0.001）。同时，在SAKI患者中，NET标志物的血浆水平与炎症指标的血清水平显著相关。此外，血清白细胞介素（IL）-2、IL-8、IL-10和肿瘤坏死因子-α在SAKI患者的生存方面与血浆NET标志物表现出交互作用。此外，三种血浆NET标志物的组合能够更准确地识别28天生存率低的SAKI患者（曲线下面积为0.857）。最后，血浆NET标志物可能独立预测SAKI患者的28天生存率。
结局较差的SAKI患者血浆NET标志物升高，可作为预测SAKI患者28天生存率的生物标志物。
