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. 2022 Apr 11;33(1):11-22.
eCollection 2022 Apr.

Novel Damage Biomarkers of Sepsis-Related Acute Kidney Injury

Dániel Ragán  1   2 , Zoltán Horváth-Szalai  1   3 , Balázs Szirmay  1 , Diána Mühl  2
Affiliations

Novel Damage Biomarkers of Sepsis-Related Acute Kidney Injury

Dániel Ragán et al. EJIFCC. .

Abstract

Sepsis-related acute kidney injury (AKI) is one of the most common complications of sepsis at the intensive care unit (ICU) with more adverse mortality rates. The early diagnosis and reliable monitoring of sepsis-related AKI are essential in achieving a favorable outcome. Novel serum and urinary biomarkers could yield valuable information during this process. Regarding the widely used Kidney Disease Improving Global Outcomes (KDIGO) classifications, the diagnosis of AKI is still based on the increase of serum creatinine levels and the decrease of urine output; however, these parameters have limitations in reflecting the extent of kidney damage, therefore more sensitive and specific laboratory biomarkers are needed for the early diagnosis and prognosis of sepsis-related AKI. Regarding this, several serum parameters are discussed in this review including presepsin and the most important actin scavenger proteins (gelsolin, Gc-globulin) while other urinary markers are also examined including cell cycle arrest biomarkers, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1), Cystatin C and actin. Novel biomarkers of sepsis-related AKI could facilitate the early diagnosis and monitoring of sepsis-related AKI.

Keywords: Sepsis-3; acute kidney injury; gelsolin; novel biomarker; presepsin; urinary Gc-globulin; urinary actin.

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Conflict of interest statement

The present research was funded by the 2020-4.1.1.-TKP2020 project (Thematic Excellence Program 2020 - National Excellence Subprogram of the Hungarian Ministry for Innovation and Technology) and partially by the Human Reproduction National Laboratory as part of the “Establishment of National Laboratories 2020” program. Zoltán Horváth-Szalai was supported by the University of Pécs, Medical School, Hungary grant (KA-2019-36). We express our special thanks for the invaluable help of the nurses and the colleagues from every participating institute.Competing interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1
Urinary actin in sepsis. U-actin levels of control and septic patients (A) along with sepsis and sepsis-related AKI patients (B) during follow-up
Figure 2
Figure 2
U-actin (A) and u-actin/u-creatinine (B) levels of the individual sepsis-related AKI stages during follow-up
Figure 3
Figure 3
Urinary Gc-globulin in sepsis and in sepsis-related AKI. Admission u-Gc-globulin/u-creatinine levels of control, septic and sepsis-related AKI patients.
See this image and copyright information in PMC

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