Susianti Hani, Sutrisnani Catur Suci, Santosa I P Adi, Febrianto Wahyu, Kusdjianto Amanda Yuanita, Kuwoyo Kevin Putro, Riyu Elita
Clinical Pathology Department, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
Central Laboratory Department, RSUD Dr. Saiful Anwar, Malang, Indonesia.
Int J Nephrol. 2024 Dec 12;2024:1555811. doi: 10.1155/ijne/1555811. eCollection 2024.
Sepsis-associated acute kidney injury (AKI) is a condition that increases in-hospital mortality and the risk of progression to CKD. The current method of detecting AKI, which relies on increased serum creatinine levels or a decrease in urine output, has low sensitivity. Early diagnosis and appropriate intervention in AKI can lead to improved patient outcomes. Several low molecular weight proteins and microRNAs detected in AKI are considered early biomarkers of AKI, such as miR-10a-5p and miR-210-3p. A cross-sectional study was conducted among 62 participants, consisting of 26 sepsis patients with AKI, 26 sepsis patients without AKI, and 10 healthy controls. AKI was determined according to KDIGO criteria. MicroRNA expression was analyzed using reverse transcription quantitative polymerase chain reaction (RT-qPCR). Statistical analysis was obtained using the Kruskal-Wallis test, Spearman's correlation coefficient, and ROC curve analysis. The median miR-10a-5p expression of the healthy controls versus sepsis with AKI versus sepsis without AKI groups was 10.38 (5.50-33.82) versus 10.32 (3.32-31.53) versus 9.76 (0.32-97.36), while the median miR-210-3p expression was 0.20 (0.03-0.41) versus 0.38 (0.04-1.24) versus 0.29 (0.06-1.67), respectively, with = 0.721 for miR-10a-5p and = 0.013 for miR-210-3 p. A significant increase in miR-210-3p expression was found in the sepsis with AKI compared to the healthy controls ( = 0.013) and sepsis without AKI ( = 0.034). miR-210-3p significantly correlated with creatinine and urea serum level ( < 0.05); miR-10a-5p did not have a significant correlation. The sensitivity and specificity of miR-10a-5p were 61.5% and 47.2%, and miR-210-3p were 84.6% and 63.9% for determining AKI. The study's findings revealed a significant increase in miR-210-3p expression in sepsis patients with AKI, indicating its potential as a promising biomarker for determining AKI. This discovery demonstrates that the diagnostic performance of miR-210-3p surpasses that of miR-10a-5p, providing a more accurate biomarker for diagnosing AKI in sepsis patients.
脓毒症相关急性肾损伤(AKI)是一种会增加住院死亡率以及进展为慢性肾脏病风险的病症。当前检测AKI的方法依赖于血清肌酐水平升高或尿量减少,其灵敏度较低。对AKI进行早期诊断和适当干预可改善患者预后。在AKI中检测到的几种低分子量蛋白质和微小RNA被视为AKI的早期生物标志物,如miR-10a-5p和miR-210-3p。对62名参与者进行了一项横断面研究,其中包括26名患有AKI的脓毒症患者、26名未患AKI的脓毒症患者以及10名健康对照者。根据KDIGO标准确定是否患有AKI。使用逆转录定量聚合酶链反应(RT-qPCR)分析微小RNA表达。采用Kruskal-Wallis检验、Spearman相关系数和ROC曲线分析进行统计分析。健康对照者、患有AKI的脓毒症患者、未患AKI的脓毒症患者组中miR-10a-5p的中位表达分别为10.38(5.50 - 33.82)、10.32(3.32 - 31.53)、9.76(0.32 - 97.36),而miR-210-3p的中位表达分别为0.20(0.03 - 0.41)、0.38(0.04 - 1.24)、0.29(0.06 - 1.67),miR-10a-5p的P = 0.721,miR-210-3p的P = 0.013。与健康对照者(P = 0.013)和未患AKI的脓毒症患者(P = 0.034)相比,发现患有AKI的脓毒症患者中miR-210-3p表达显著增加。miR-210-3p与血清肌酐和尿素水平显著相关(P < 0.05);miR-10a-5p无显著相关性。miR-10a-5p诊断AKI的灵敏度和特异性分别为61.5%和47.2%,miR-210-3p分别为84.6%和63.9%。该研究结果显示,患有AKI的脓毒症患者中miR-210-3p表达显著增加,表明其作为确定AKI的有前景生物标志物的潜力。这一发现表明,miR-210-3p的诊断性能优于miR-10a-5p,为诊断脓毒症患者的AKI提供了更准确的生物标志物。