Utility of plasma suPAR to identify AKI and sepsis associated AKI in critically ill children

作者：Jing Xu, Jiao Chen, Min Li, Zhen Jiang, Fang Fang, Junlong Hu, Yueying Zhou, Huiwen Li, Zhenjiang Bai, Xiaozhong Li, Guoping Lü, Yanhong Li · 发表于：iScience · 年份：2024 · DOI：10.1016/j.isci.2024.111247 · 被引用次数：5 · 研究领域：Acute Kidney Injury Research、Renal function and acid-base balance、Mechanical Circulatory Support Devices

Current biomarkers for sepsis-associated acute kidney injury (SA-AKI) lack specificity. The role of soluble urokinase plasminogen activator receptor (suPAR) in discriminating AKI and SA-AKI in children remains elusive. This prospective multicenter study was conducted in critically ill children cohorts using a derivation-validation design, and plasma samples were collected within first 24 h after admission. Plasma suPAR was independently associated with AKI, SA-AKI, and PICU mortality, even after adjustment for confounding variables. This multiclass classification model had the micro-average AUC of 0.89 with specificity of 97.6% for discriminating non-septic AKI, and specificity of 99.0% for discriminating SA-AKI, based on the cut-off values of 1.5 and 2.3-fold baseline in serum creatinine (SCr) and 4.5 and 11.2 ng/mL in plasma suPAR. The multiclass classification model provides the cutoffs for plasma suPAR and SCr and specifically discriminates critically ill children at high risk of non-septic AKI and SA-AKI, which can facilitate clinical utility.