Reports of Biochemistry
and Molecular Biology
Mon, Jan 20, 2025
[Archive]
Volume 13, Issue 2 (Vol.13 No.2 Jul 2024)
rbmb.net 2024, 13(2): 144-153 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Kahar L A. Interleukin-6 and Procalcitonin as Potential Predictors of Acute Kidney Injury Occurrence in Patients with Sepsis. rbmb.net 2024; 13 (2) :144-153
URL: http://rbmb.net/article-1-1411-en.html
URL: http://rbmb.net/article-1-1411-en.html
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Andalas University, Dr. M. Djamil General Hospital.
Abstract: (244 Views)
Background: Timely treatment actions are critical for the early detection of sepsis in patients at high risk of acute kidney injury (AKI). This study aimed to investigate inflammatory biomarkers as potential predictors of AKI in patients with sepsis.
Methods: This prospective observational cohort study included 300 patients who received treatment in the Intensive Care Unit (ICU) of hospitals located in Padang, Indonesia. We obtained blood samples to evaluate inflammatory biomarkers, such as interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a), and procalcitonin (PCT). AKI development was predicted using multivariate logistic regression analysis to identify independent inflammatory biomarkers.
Results: IL-6, TNF-α, and PCT levels were markedly elevated in patients who developed AKI compared with those who did not (p < 0.001). The multivariable logistic regression analysis showed that IL-6 (OR = 1.82; 95% CI = 1.25-2.66; p = 0.002) and PCT (OR = 2.45; 95% CI = 1.58-3.80; p < 0.001) can both predict the development of AKI in patients with sepsis. The area under the curve (AUC) for IL-6 was 0.70, whereas the AUC for PCT was 0.81. These findings demonstrate that IL-6 and PCT exhibit strong predictive abilities for the onset of AKI in patients with sepsis. The ideal threshold values for IL-6 and PCT were 12.91 pg/mL and 1.79 ng/mL, respectively.
Conclusion: IL-6 and PCT can serve as inflammatory biomarkers for predicting the occurrence of AKI in patients with sepsis.
Methods: This prospective observational cohort study included 300 patients who received treatment in the Intensive Care Unit (ICU) of hospitals located in Padang, Indonesia. We obtained blood samples to evaluate inflammatory biomarkers, such as interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a), and procalcitonin (PCT). AKI development was predicted using multivariate logistic regression analysis to identify independent inflammatory biomarkers.
Results: IL-6, TNF-α, and PCT levels were markedly elevated in patients who developed AKI compared with those who did not (p < 0.001). The multivariable logistic regression analysis showed that IL-6 (OR = 1.82; 95% CI = 1.25-2.66; p = 0.002) and PCT (OR = 2.45; 95% CI = 1.58-3.80; p < 0.001) can both predict the development of AKI in patients with sepsis. The area under the curve (AUC) for IL-6 was 0.70, whereas the AUC for PCT was 0.81. These findings demonstrate that IL-6 and PCT exhibit strong predictive abilities for the onset of AKI in patients with sepsis. The ideal threshold values for IL-6 and PCT were 12.91 pg/mL and 1.79 ng/mL, respectively.
Conclusion: IL-6 and PCT can serve as inflammatory biomarkers for predicting the occurrence of AKI in patients with sepsis.
Type of Article: Original Article |
Subject:
Biochemistry
Received: 2024/06/15 | Accepted: 2024/07/22 | Published: 2025/01/4
Received: 2024/06/15 | Accepted: 2024/07/22 | Published: 2025/01/4
References
1. Jarczak D, Kluge S, Nierhaus A. Sepsis-Pathophysiology and therapeutic concepts. Front Med (Lausanne). 2021;8:628302. [DOI:10.3389/fmed.2021.628302] [PMID] []
2. Arora J, Mendelson AA, Fox-Robichaud A. Sepsis: network pathophysiology and implications for early diagnosis. Am J Physiol. 2023;324(5):R613-24. [DOI:10.1152/ajpregu.00003.2023] [PMID] []
3. Prest J, Nguyen T, Rajah T, Prest AB, Sathanantan M, Jeganathan N. Sepsis-related mortality rates and trends based on site of infection. Crit Care Explor. 2022;4(10):e0775. [DOI:10.1097/CCE.0000000000000775] [PMID] []
4. Manrique-Caballero CL, Rio-Pertuz GD, Gomez H. Sepsis-associated acute kidney injury. Crit Care Clin. 2021;37(2):279-301. [DOI:10.1016/j.ccc.2020.11.010] [PMID] []
5. He FF, Wang YM, Chen YY, Huang W, Li ZQ, Zhang C. Sepsis-induced AKI: from pathogenesis to therapeutic approaches. Front Pharmacol. 2022;13:981578. [DOI:10.3389/fphar.2022.981578] [PMID] []
6. Pais T, Jorge S, Lopes JA. Acute kidney injury in sepsis. Int J Mol Sci. 2024;25(11):5924. [DOI:10.3390/ijms25115924] [PMID] []
7. Peerapornratana S, Manrique-Caballero CL, Gómez H, Kellum JA. Acute kidney injury in patients with sepsis: A contemporary review. Kidney Int Rep. 2020;5(6):867-78.
8. Rittirsch D, Redl H, Huber-Lang M. Biomarkers in sepsis: Current status and perspectives. Crit Care Med. 2021;49(3):505-14.
9. Sun J, Zhang X, Wang H, Yang Y, Li H, Chen L. The prognostic value of interleukin-6 in sepsis: A meta-analysis. Crit Care. 2018;22(1):256.
10. He X, Wang Y, Zhang Z, Wang X, Zhao J, Liu Y, et al. Prognostic value of procalcitonin in sepsis: A systematic review and meta-analysis. PLoS One. 2018;13(1):e0191808.
11. Zhang Z, Ni H, Li X, Li X, Wang H, Wang X. The prognostic value of tumor necrosis factor-alpha in sepsis: A meta-analysis. Medicine (Baltimore). 2018;97(5):e9765.
12. Yunus I, Fasih A, Wang Y. The use of procalcitonin in the determination of severity of sepsis, patient outcomes and infection characteristics. PLoS One. 2018;13(11):e0206527. [DOI:10.1371/journal.pone.0206527] [PMID] []
13. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. [DOI:10.1001/jama.2016.0287] [PMID] []
14. KDIGO AKI Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012;2(1):1-138.
15. Kellum JA, Lameire N. Diagnosis, evaluation, and management of acute kidney injury: A KDIGO summary (Part 1). Crit Care. 2013;17(1):204. [DOI:10.1186/cc11454] [PMID] []
16. Liu B, Chen Y, Wang X, Zhou D, Zhang L, Li L. Combined use of procalcitonin and interleukin-6 to predict acute kidney injury in patients with sepsis: A systematic review and meta-analysis. Crit Care. 2019;23(1):267.
17. Liu C, Fang C, Xie L. The value of interleukin-6 (IL-6) within 6 hours after birth in the prompt diagnosis of early-onset neonatal sepsis. Translat Ped. 2020;9(5):629-35. [DOI:10.21037/tp-20-239] [PMID] []
18. Cecconi M, Evans L, Levy M, Rhodes A. Sepsis and septic shock. Lancet. 2018;391(10131):1893-905. [DOI:10.1016/S0140-6736(18)30696-2] [PMID]
19. Kaukonen KM, Bailey M, Pilcher D, Cooper DJ, Bellomo R. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med. 2015 Jul 23;372(25):2399-408. [DOI:10.1056/NEJMoa1415236] [PMID]
20. Opal SM, van der Poll T. Endotoxins and other sepsis triggers. Crit Care Med. 2015;43(9):1983-92.
21. Kahar LA, Yusrawati Y, Jamsari J, Maskoen T, Aribowo K, Sari WM. The role of vitamin D binding protein and vitamin D level in mortality of sepsis patients. Rep Biochem Mol Biol. 2023;12(3):366-73.
22. Chun K, Chung W, Kim AJ, Kim H, Ro H, Chang JH, et al. Association between acute kidney injury and serum procalcitonin levels and their diagnostic usefulness in critically ill patients. Sci Rep. 2019;9:4777. [DOI:10.1038/s41598-019-41291-1] [PMID] []
23. Fu G, Zhan HC, Li HL, Lu J, Chen Y, Wu L, et al. Association between procalcitonin and acute kidney injury in patients with bacterial septic shock. Blood Purif. 2021;50(6):790-9. [DOI:10.1159/000512351] [PMID]
24. Meisel C, Schefold JC, Pschowski R, Baumann T, Hetzger K, Gregor J, et al. Granulocyte macrophage colony-stimulating factor to reverse sepsis-associated immunosuppression: A double-blind, randomized, placebo-controlled multicenter trial. Am J Respir Crit Care Med. 2009;180(5):439-47. [DOI:10.1164/rccm.200903-0363OC] [PMID]
25. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021;49(12):e1063-143.
26. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43(1):304-77. [DOI:10.1007/s00134-017-4683-6] [PMID]
27. Nour Z, Elhamamsy K, Ehsan I, Fawaz L, Shaker O, Mossallam D, et al. MicroRNAs as potential diagnostic new biomarkers in diagnosis of sepsis in pediatric patients. Rep Biochem Mol Biol. 2022;11(2):327-35.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
