Value of plasma the soluble CD14 subtype in early diagnosis of sepsis patients with acute renal injury

Objective To evaluate the diagnostic value of plasma the soluble CD14 subtype (sCD14-ST, renamed as presepsin) in early diagnosis of sepsis patients with acute kidney injury (AKI).

Methods A total of 110 patients with AKI in intensive care unit(ICU)of Wuhu Hospital Affiliated to East China Normal University from January 2021 to December 2022 were prospectively selected. The patients were divided into AKI stage 1 group (n=34), AKI stage 2 group (n=36) and AKI stage 3 group (n=40) according to the staging criteria defined byKidney Disease: Improving Global Outcomes (KDIGO) in 2012, and 53 non-AKI patients in the same period were selected as the control group. The patients were further divided into non-sepsis group and sepsis group according to whether combined sepsis or not. Plasma Presepsin levels were recorded in all the patients. Receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of Presepsin inearly sepsis in AKI patients, and the optimal cutoff value was found using Jorden index.

Results The level of Presepsin in the sepsis group was higher than that in non-sepsis group (P < 0.05). In non-sepsis patients, the level of Presepsin increased gradually with the aggravation of renal function injury (P < 0.05). The level of Presepsin in stage 3 AKI group was higher than that in non-AKI group (P < 0.01). ROC curve analysis results showed that thearea under the curve (AUC) of Presepsin level for diagnosing sepsis in stage 1 AKI group, stage 2 AKI group and stage 3 AKI group was smaller than that in non-AKI group (P > 0.05).

Conclusion Presepsin can be used as a marker for early diagnosis of sepsis in AKI patients, but different thresholds should be used according to the severity of renal impairment.