Relationship between Serum APRIL,LRG1,Syndecan-1 and Renal Function and Short-Term Prognosis in Patients with Sepsis Combined with Acute Kidney Injury
Objective:To investigate the relationship between serum a proliferation-inducing ligand(APRIL),leucine-rich α-2 glycoprotein 1(LRG1),multiligand proteoglycan-1(Syndecan-1)and renal function and short-term prognosis in patients with sepsis combined with acute kidney injury(AKI).Methods:247 patients with sepsis admitted to Jinan Fifth People's Hospital from January 2021 to January 2023 were selected,and patients were divided into non-AKI group(122 cases)and AKI group(125 cases)according to whether AKI was combined,patients with sepsis combine with AKI were divided into death group and survival group according to the 30 days clinical outcome.Serum APRIL,LRG1 and Syndecan-1 were detected by enzyme-linked immunosorbent assay,and renal function indexes[urinary albumin/creatinine ratio(UACR),estimated glomerular filtration rate(eGFR)]were calculated.The correlation between serum APRIL,LRG1,Syndecan-1 and UACR and eGFR in patients with sepsis combine with AKI were analyzed by Spearman correlation analysis.The influencing factors of short-term prognosis in patients with sepsis combine with AKI were analyzed by multivariate Logistic regression,the predictive value of serum APRIL,LRG1 and Syndecan-1 levels for short-term prognosis in patients with sepsis combine with AKI were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of serum APRIL,LRG1,Syndecan-1 and UACR in AKI group were higher than those in non-AKI group,and eGFR was lower than that in non-AKI group(P＜0.05).Spearman correlation analysis showed that,serum APRIL,LRG1 and Syndecan-1 were positively correlated with UACR and negatively correlated with eGFR in patients with sepsis combine with AKI(P＜0.05).The 30 day mortality rate of 125 patients with sepsis combine with AKI was 40.80％.The levels of serum APRIL,LRG1,Syndecan-1 and UACR in death group were higher than those in survival group,and eGFR was lower than that in survival group(P＜0.05).Multivariate Logistic regression analysis showed that,the increase of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,UACR,APRIL,LRG1 and Syndecan-1 were independent risk factors for short-term prognosis in patients with sepsis combine with AKI,and the increase of eGFR was an independent protective factor(P＜0.05).The area under the curve of combined prediction of serum APRIL,LRG1 and Syndecan-1 levels was 0.908,which was greater than that of serum APRIL,LRG1 and Syndecan-1 levels alone.Conclusion:The increase of serum APRIL,LRG1 and Syndecan-1 levels are closely relate to the decrease of renal function in patients with sepsis combine with AKI,and are independent risk factors for poor short-term prognosis in patients with sepsis combined with AKI.The combination of serum APRIL,LRG1 and Syndecan-1 levels has a high value in predicting the short-term prognosis in patients with sepsis combine with AKI.
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