Introduction:
Sepsis-associated acute kidney injury is linked to high mortality rates and unfavorable outcomes. Systemic inflammation and endothelial dysfunction are key factors contributing to sepsis-associated acute kidney injury. Our study aimed to assess the variation in serum thrombomodulin, an endothelial dysfunction marker, between sepsis patients and those with sepsis-associated acute kidney injury, to investigate the potential involvement of thrombomodulin in the development of sepsis-associated acute kidney injury and its predictive value.
Methods:
The study included 51 patients with sepsis admitted to the Department of Critical Care Medicine at the First Affiliated Hospital of Soochow University from July to December 2023, with 20 patients having sepsis-related acute kidney injury. Patient data such as age, gender, body mass index, history of chronic underlying diseases, and primary infection source were collected. Vital signs, blood tests, organ function tests, electrolytes, blood gas analysis, APACHE II, and SOFA scores were recorded upon admission. Thrombomodulin levels were measured on days 1, 3, and 7 post-diagnosis. Statistical tests like t-tests, chi-square tests, rank sum tests, and analysis of variance were used for comparisons. Correlation analysis utilized Spearman or Pearson methods. Multivariate logistic regression was employed to identify risk factors for sepsis-related acute kidney injury. Additionally, an ROC curve was plotted to assess the predictive value of thrombomodulin in sepsis-associated acute kidney injury.
Results:
The distribution of infection sites among the patients included 25 cases of pulmonary infection (49.02%), 21 cases of abdominal infection (41.18%), 3 cases of skin and soft tissue infection (5.88%), and 2 cases of intracranial infection (3.92%). No statistically significant differences were observed in gender, age, white blood cell count, etc. between the sepsis and sepsis-associated acute kidney injury groups. The mortality rate in the sepsis-related acute kidney injury group was notably higher than in the sepsis group (P<0.05). Significant variances were found between the groups in terms of chronic kidney disease, APACHE II score, and SOFA score (P<0.05). Levels of thrombomodulin on days 1, 3, and 7 exhibited statistical differences between the sepsis and sepsis-related renal injury groups (P<0.05). Thrombomodulin showed correlation with mortality, presence of liver disease, and use of vasopressors (P<0.05). Multivariate logistic regression analysis identified thrombomodulin on day 3 as an independent predictor of sepsis-associated renal injury. Furthermore, ROC curves were plotted between the two groups, yielding AUC values of 0.846, 0.923, and 0.824 on day 1, day 3, and day 7 respectively (P<0.05).
Conclusions:
Thrombomodulin may be a potential predictor of sepsis-associated acute kidney injury and could be associated with mortality.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.