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Abstract

Objective: To evaluate critically ill patients who had sepsis and how various kidney-related measurements, including eGFR, NGAL, CysC, and the urinary enzyme NAG, predict the onset of sepsis-induced renal damage. Methods: The 135 individuals who were admitted to our sepsis intensive care within 2 years to the end of early 2024 were recruited on a prospective basis and were enrolled based on the predefined criteria. Upon admission, they were dichotomized into 2 groups of participants who developed septic-associated kidney injury (82) and without (53). A comparison of baseline laboratory analyses and blood and urine baseline examinations in the groups was done. Single-variable and multi-variable logistic models were used to determine aspects associated with the development of kidney dysfunction. Receiver-operating characteristic curves were used to determine predictive performance of each biomarker and each combination of biomarkers. Results: The SA-AKI group, as compared to the patients with no renal involvement, had significantly greater values in a number of different clinical indices, such as inflammatory cell count, serum levels of procalcitonin, neutrophils: lymphocyte ratio, platelet counts, serum levels of NGAL, serum levels of CysC, and urinary NAG as well as changed eGFR. In the meantime, their SOFA and APACHE II evaluations were also less inclined (all comparisons were statistically significant). The preliminary regression models implied that there were many variables that were linked to SA-AKI. Nevertheless, it is only 4 measures of NGAL in blood, CysC in serum, NAG in urine and eGFR that were not confounded and correlated with the condition. Their values of AUROC were 0.875, 0.889, 0.797 and 0.864 respectively; the combined model of these indicators yielded a higher value of 0.946. Conclusion: The early signs of inevitability of sepsis-associated kidney injury are abnormal eGFR, NAG, CysC, and NGAL among septic ICU patients, and the combination of all these 4 markers offers the most potent predictive power.

Article Type

Original Study

First Page

877

Last Page

883

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