Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 6:8:751299.
doi: 10.3389/fmolb.2021.751299. eCollection 2021.

Potential Value of TNF-α (-376 G/A) Polymorphism and Cystatin C (CysC) in the Diagnosis of Sepsis Associated Acute Kidney Injury (S-AK I) and Prediction of Mortality in Critically Ill patients

Hiba S Al-Amodi  1 , Shimaa Abdelsattar  2 , Zeinab A Kasemy  3 , Hanan M Bedair  4 , Hany S Elbarbary  5   6 , Hala F M Kamel  1   7
Affiliations

Potential Value of TNF-α (-376 G/A) Polymorphism and Cystatin C (CysC) in the Diagnosis of Sepsis Associated Acute Kidney Injury (S-AK I) and Prediction of Mortality in Critically Ill patients

Hiba S Al-Amodi et al. Front Mol Biosci. .

Abstract

Sepsis Associated Kidney Injury represents a major health concern as it is frequently associated with increased risk of mortality and morbidity. We aimed to evaluate the potential value of TNF-α (-376 G/A) and cystatin C in the diagnosis of S-AKI and prediction of mortality in critically ill patients. This study included 200 critically ill patients and 200 healthy controls. Patients were categorized into 116 with acute septic shock and 84 with sepsis, from which 142 (71%) developed S-AKI. Genotyping of TNF-α (-376 G/A) was performed by RT-PCR and serum CysC was assessed by Enzyme Linked Immunosorbent Assay. Our results showed a highly significant difference in the genotype frequencies of TNF-α (-376 G/A) SNP between S-AKI and non-AKI patients (p < 0.001). Additionally, sCysC levels were significantly higher in the S-AKI group (p = 0.011). The combination of both sCysC and TNF-α (-376 G/A) together had a better diagnostic ability for S-AKI than sCysC alone (AUC = 0.610, 0.838, respectively). Both GA and AA genotypes were independent predictors of S-AKI (p= < 0.001, p = 0.002 respectively). Additionally, sCysC was significantly associated with the risk of S-AKI development (Odds Ratio = 1.111). Both genotypes and sCysC were significant predictors of non-survival (p < 0.001), suggesting their potential role in the diagnosis of S-AKI and prediction of mortality.

Keywords: TNF-α; critically ill patients; cystatin C; polymorphism; sepsis associated acute kidney injury.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
ROC curve analysis for CystC to discriminate S-AKI patients (No. = 142) from non-AKI (No. = 58) in total patients.
FIGURE 2
FIGURE 2
Kaplan-Meier survival curve for Overall Survival with CystC in total patients (No. = 200).
FIGURE 3
FIGURE 3
Kaplan-Meier survival curve for Overall Survival with TNF-α (rs1800750) in total patients (No. = 200).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Abdelsattar S., Kasemy Z., Elsayed M., Elrahem T., Zewain S. (2021). Targeted Metabolomics as a Tool for the Diagnosis of Kidney Disease in Type II Diabetes Mellitus. Br. J. Biomed. Sci., 1–7. 10.1080/09674845.2021.1894705 - DOI - PubMed
    1. Åhlström A., Tallgren M., Peltonen S., Pettilä V. (2004). Evolution and Predictive Power of Serum Cystatin C in Acute Renal Failure. Cn 62, 344–350. 10.5414/cnp62344 - DOI - PubMed
    1. Al-Beladi F. (2015). Cystatin C Is an Early Marker of Contrast-Induced Nephropathy in Patients with Sepsis in the Intensive Care Unit. Saudi J. Kidney Dis. Transpl. 26, 718. 10.4103/1319-2442.160170 - DOI - PubMed
    1. Bagshaw S. M., Gibney R. T. N. (2008). Conventional Markers of Kidney Function. Crit. Care Med. 36, S152–S158. 10.1097/ccm.0b013e318168c613 - DOI - PubMed
    1. Baker M. (2005). In Biomarkers We Trust? Nat. Biotechnol. 23, 297–304. 10.1038/nbt0305-297 - DOI - PubMed