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Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study
INTRODUCTION: A major complication of sepsis is the development of acute kidney injury (AKI). Recently, it was shown that intracellular actin released from damaged tissues appears in the urine of patients with multiple organ dysfunction syndrome. Our aims were to measure urinary actin (u-actin) conc...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312921/ https://www.ncbi.nlm.nih.gov/pubmed/34310652 http://dx.doi.org/10.1371/journal.pone.0255266 |
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author | Ragán, Dániel Kustán, Péter Horváth-Szalai, Zoltán Szirmay, Balázs Bugyi, Beáta Ludány, Andrea Miseta, Attila Nagy, Bálint Mühl, Diána |
author_facet | Ragán, Dániel Kustán, Péter Horváth-Szalai, Zoltán Szirmay, Balázs Bugyi, Beáta Ludány, Andrea Miseta, Attila Nagy, Bálint Mühl, Diána |
author_sort | Ragán, Dániel |
collection | PubMed |
description | INTRODUCTION: A major complication of sepsis is the development of acute kidney injury (AKI). Recently, it was shown that intracellular actin released from damaged tissues appears in the urine of patients with multiple organ dysfunction syndrome. Our aims were to measure urinary actin (u-actin) concentrations of septic and control patients and to test if u-actin levels could predict AKI and mortality. METHODS: Blood and urine samples were collected from septic and sepsis-related AKI patients at three time points (T1-3): T1: within 24 hours after admission; T2: second day morning; T3: third day morning of follow-up. Patients with malignancies needing palliative care, end-stage renal disease or kidney transplantation were excluded. Serum and u-actin levels were determined by quantitative Western blot. Patients were categorized by the Sepsis-3 and KDIGO AKI classifications. RESULTS: In our study, 17 septic, 43 sepsis-induced AKI and 24 control patients were enrolled. U-actin levels were higher in septic patients compared with controls during follow-up (p<0.001). At T1, the septic and sepsis-related AKI groups also showed differences (p<0.001), yet this increase was not statistically significant at T2 and T3. We also detected significantly elevated u-actin concentrations in AKI-2 and AKI-3 septic patients compared with AKI-1 septic patients (p<0.05) at T1 and T3, along with a significant increase in AKI-2 septic patients compared with AKI-1 septic patients at T2 (p<0.01). This tendency remained the same when referring u-actin to urine creatinine. Parameters of first-day septic patient samples could discriminate AKI from non-AKI state (AUC ROC, p<0.001): u-actin: 0.876; se-creatinine: 0.875. Derived cut-off value for u-actin was 2.63 μg/L (sensitivity: 86.0%, specificity: 82.4%). CONCLUSION: U-actin may be a complementary diagnostic biomarker to se-creatinine in sepsis-related AKI while higher u-actin levels also seem to reflect the severity of AKI. Further investigations may elucidate the importance of u-actin release in sepsis-related AKI. |
format | Online Article Text |
id | pubmed-8312921 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-83129212021-07-31 Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study Ragán, Dániel Kustán, Péter Horváth-Szalai, Zoltán Szirmay, Balázs Bugyi, Beáta Ludány, Andrea Miseta, Attila Nagy, Bálint Mühl, Diána PLoS One Research Article INTRODUCTION: A major complication of sepsis is the development of acute kidney injury (AKI). Recently, it was shown that intracellular actin released from damaged tissues appears in the urine of patients with multiple organ dysfunction syndrome. Our aims were to measure urinary actin (u-actin) concentrations of septic and control patients and to test if u-actin levels could predict AKI and mortality. METHODS: Blood and urine samples were collected from septic and sepsis-related AKI patients at three time points (T1-3): T1: within 24 hours after admission; T2: second day morning; T3: third day morning of follow-up. Patients with malignancies needing palliative care, end-stage renal disease or kidney transplantation were excluded. Serum and u-actin levels were determined by quantitative Western blot. Patients were categorized by the Sepsis-3 and KDIGO AKI classifications. RESULTS: In our study, 17 septic, 43 sepsis-induced AKI and 24 control patients were enrolled. U-actin levels were higher in septic patients compared with controls during follow-up (p<0.001). At T1, the septic and sepsis-related AKI groups also showed differences (p<0.001), yet this increase was not statistically significant at T2 and T3. We also detected significantly elevated u-actin concentrations in AKI-2 and AKI-3 septic patients compared with AKI-1 septic patients (p<0.05) at T1 and T3, along with a significant increase in AKI-2 septic patients compared with AKI-1 septic patients at T2 (p<0.01). This tendency remained the same when referring u-actin to urine creatinine. Parameters of first-day septic patient samples could discriminate AKI from non-AKI state (AUC ROC, p<0.001): u-actin: 0.876; se-creatinine: 0.875. Derived cut-off value for u-actin was 2.63 μg/L (sensitivity: 86.0%, specificity: 82.4%). CONCLUSION: U-actin may be a complementary diagnostic biomarker to se-creatinine in sepsis-related AKI while higher u-actin levels also seem to reflect the severity of AKI. Further investigations may elucidate the importance of u-actin release in sepsis-related AKI. Public Library of Science 2021-07-26 /pmc/articles/PMC8312921/ /pubmed/34310652 http://dx.doi.org/10.1371/journal.pone.0255266 Text en © 2021 Ragán et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ragán, Dániel Kustán, Péter Horváth-Szalai, Zoltán Szirmay, Balázs Bugyi, Beáta Ludány, Andrea Miseta, Attila Nagy, Bálint Mühl, Diána Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study |
title | Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study |
title_full | Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study |
title_fullStr | Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study |
title_full_unstemmed | Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study |
title_short | Urinary actin, as a potential marker of sepsis-related acute kidney injury: A pilot study |
title_sort | urinary actin, as a potential marker of sepsis-related acute kidney injury: a pilot study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312921/ https://www.ncbi.nlm.nih.gov/pubmed/34310652 http://dx.doi.org/10.1371/journal.pone.0255266 |
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