Presepsin and prognostic nutritional index are predictors of septic acute kidney injury, renal replacement therapy initiation in sepsis patients, and prognosis in septic acute kidney injury patients: a pilot study

BMC Nephrology

Osamu Umegaki¹  Yuichiro Shimoyama¹  Noriko Kadono¹  Toshiaki Minami² 

[1] Department of Anesthesiology, Osaka Medical College, Intensive Care Unit, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, 569-8686, Osaka, Japan;Department of Anesthesiology, Osaka Medical College, Osaka Medical College Hospital, Takatsuki, Japan;

关键词: Presepsin;    Sepsis;    Sepsis-3 definition;    Inflammation-based prognostic scores;    Acute kidney injury;    Renal replacement therapy;   

DOI  :  10.1186/s12882-021-02422-x

来源: Springer

【 摘 要 】

BackgroundSepsis is the most common cause of acute kidney injury (AKI) among critically ill patients. This study aimed to determine whether presepsin is a predictor of septic acute kidney injury, renal replacement therapy initiation (RRTi) in sepsis patients, and prognosis in septic AKI patients.MethodsPresepsin values were measured immediately after ICU admission (baseline) and on Days 2, 3, and 5 after ICU admission. Glasgow Prognostic Score (GPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, Prognostic Index, and Prognostic Nutritional Index (PNI) were measured at baseline, and total scores (“inflammation-presepsin scores [iPS]”) were calculated for category classification. Presepsin values, inflammation-based prognostic scores, and iPS were compared between patients with and without septic AKI or RRTi and between survivors and non-survivors.ResultsReceiver operating characteristic curve analyses identified the following variables as predictors of septic AKI and RRTi in sepsis patients: presepsin on Day 1 (AUC: 0.73) and Day 2 (AUC: 0.71) for septic AKI, and presepsin on Day 1 (AUC: 0.71), Day 2 (AUC: 0.9), and Day 5 (AUC: 0.96), Δpresepsin (Day 2 – Day 1) (AUC: 0.84), Δpresepsin (Day 5 – Day 1) (AUC: 0.93), and PNI (AUC: 0.72) for RRTi. Multivariate logistic regression analyses identified presepsin on Day 2 as a predictor of prognosis in septic AKI patients.ConclusionsPresepsin and PNI were found to be predictors of septic AKI, RRTi in sepsis patients, and prognosis in septic AKI patients.

【 授权许可】

CC BY