Thrombomodulin: A potential biomarker for sepsis-associated acute kidney injury resulting from bacterial infections

 

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https://storage.unitedwebnetwork.com/files/1099/520c9293014388a8ed6007e8d6db463e.pdf
Thrombomodulin: A potential biomarker for sepsis-associated acute kidney injury resulting from bacterial infections

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Hao
Hong
Hao Hong 1925924373@qq.com The First Affiliated Hospital of Soochow University Critical care medicine Suzhou China *
Yuting Wang wangytcool@163.com The First Affiliated Hospital of Soochow University Laboratory Nephrology Suzhou China -
Mengya Xiao 18214816067@163.com The First Affiliated Hospital of Soochow University Laboratory Nephrology Suzhou China -
Junyao Zheng 1282863145@qq.com The First Affiliated Hospital of Soochow University Laboratory Nephrology Suzhou China -
Haimin Shi 2742401025@qq.com The First Affiliated Hospital of Soochow University Laboratory Nephrology Suzhou China -
Ming Li sudahhh@qq.com The First Affiliated Hospital of Soochow University Laboratory Nephrology Suzhou China -
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Thrombomodulin (TM) is a single transmembrane, multidomain glycoprotein receptor primarily expressed by vascular endothelial cells, although it is also found in several other cell types, including neutrophils, synovial lining cells, monocytes, nucleated cells, and osteoblasts. Initially, TM garnered significant attention from researchers because of its ability to regulate coagulation through thrombin activity.

In this study, we aimed to investigate the predictive value of TM in SA-AKI resulting from bacterial infections. The progression of SA-AKI frequently necessitates the administration of vasoactive drugs and Continuous Renal Replacement Therapy (CRRT) to sustain circulation and enhance the internal environment as well as to address the progression of AKI. Consequently, we performed a subgroup analysis to determine whether TM retained its predictive value during the administration of vasoactive drugs and CRRT.

One-way analysis of variance (ANOVA) was applied to variables exhibiting normal distribution and homogeneous variance, whereas rank sum tests were utilized for non-normally distributed variables. Spearman’s correlation analysis was performed to assess relationships. Binary and ordered logistic regression analyses were conducted to evaluate the independent relationships with SA-AKI. A receiver operating characteristic (ROC) curve was employed to determine di-agnostic accuracy.

Thrombomodulin was significantly elevated in patients with AKI compared to that in non-AKI patients, and the odds ratio for thrombomodulin was 1.168 in a multivariable logistic regression analysis. The Area under curve (AUC) value for thrombomodulin in SA-AKI was 0.811. In subgroup analysis, thrombomodulin expression was significantly higher in the vasoactive drug group. The AUC of thrombomodulin with vasopressor use was 0.704. In the group that did not utilize vasoactive drugs, the AUC of thrombomodulin in SA-AKI was 0.813. Thrombomodulin expression was significantly higher in the Continuous Renal Replacement Therapy (CRRT) group. The AUC of Thrombomodulin (TM) when CRRT was used was 0.796. In the group that did not receive CRRT, the AUC of thrombomodulin predicted by SA-AKI was 0.741.

Thrombomodulin may be valuable in independently predicting SA-AKI.

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