Heparin-binding protein as a novel biomarker for sepsis-related acute kidney injury

Pajenda, Sahra; Figurek, Andreja; Wagner, Ludwig; Gerges, Daniela; Schmidt, Alice; Herkner, Harald; Winnicki, Wolfgang

doi:10.7717/peerj.10122

Cited by 4 publications

(11 citation statements)

References 59 publications

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“…Here we found that septic patients to whom renal replacement therapy had to be administrated had higher serum levels of HBP at admission, whereas in the non-septic patients such a correlation was not found. This is in line with previous research, reporting the highest HBP levels among sepsis patients with AKI undergoing RRT [ 32 ]. A significant association between HBP serum concentration and peak creatinine was found only in the sepsis group.…”

Section: Discussionsupporting

confidence: 93%

“…Pajenda et al . reported significantly higher mean values of HBP among sepsis patients with AKI compared to sepsis patients without AKI [ 32 ]. HBP adds a predictive value to other known risk factors for S-AKI, in 511 sepsis patients of whom 20% developed AKI stage 2–3 within 5 days [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another potential marker for sepsis-induced AKI is heparin-binding protein (HBP) [ 30 – 32 ]. HBP, is a cationic antimicrobial protein produced in neutrophils and stored in both primary granules and secretory vesicles, and is rapidly released e .…”

Section: Introductionmentioning

confidence: 99%

“…HBP influences vascular permeability and acts as a chemoattractant for cells [ 34 – 36 ]. Several studies have shown that HBP is a promising biomarker for sepsis and circulatory failure and correlates with the development of AKI in septic subjects [ 30 – 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Hepcidin, in contrast to heparin binding protein, does not portend acute kidney injury in patients with community acquired septic shock

Olinder,

Stjernqvist,

Lindén

et al. 2024

PLoS ONE

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Background Acute kidney injury (AKI) is a common and severe complication in patients treated at an Intensive Care Unit (ICU). The pathogenesis of AKI has been reported to involve hypoperfusion, diminished oxygenation, systemic inflammation, and damage by increased intracellular iron concentration. Hepcidin, a regulator of iron metabolism, has been shown to be associated with sepsis and septic shock, conditions that can result in AKI. Heparin binding protein (HBP) has been reported to be associated with sepsis and AKI. The aim of the present study was to compare serum hepcidin and heparin binding protein (HBP) levels in relation to AKI in patients admitted to the ICU. Methods One hundred and forty patients with community acquired illness admitted to the ICU within 24 hours after first arrival to the hospital were included in the study. Eighty five of these patients were diagnosed with sepsis and 55 with other severe non-septic conditions. Logistic and linear regression models were created to evaluate possible correlations between circulating hepcidin and heparin-binding protein (HBP), stage 2–3 AKI, peak serum creatinine levels, and the need for renal replacement therapy (RRT). Results During the 7-day study period, 52% of the 85 sepsis and 33% of the 55 non-sepsis patients had been diagnosed with AKI stage 2–3 already at inclusion. The need for RRT was 20% and 15%, respectively, in the groups. Hepcidin levels at admission were significantly higher in the sepsis group compared to the non-sepsis group but these levels did not significantly correlate to the development of stage 2–3 AKI in the sepsis group (p = 0.189) nor in the non-sepsis group (p = 0.910). No significant correlation between hepcidin and peak creatinine levels, nor with the need for RRT was observed. Stage 2–3 AKI correlated, as expected, significantly with HBP levels at admission in both groups (Odds Ratio 1.008 (CI 1.003–1.014, p = 0.005), the need for RRT, as well as with peak creatinine in septic patients. Conclusion Initial serum hepcidin, and HBP levels in patients admitted to the ICU are biomarkers for septic shock but in contrast to HBP, hepcidin does not portend progression of disease into AKI or a later need for RRT. Since hepcidin is a key regulator of iron metabolism our present data do not support a decisive role of initial iron levels in the progression of septic shock into AKI.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hepcidin, in contrast to heparin binding protein, does not portend acute kidney injury in patients with community acquired septic shock

Olinder,

Stjernqvist,

Lindén

et al. 2024

PLoS ONE

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“…Linder et al [48] Infection with organ dysfunction (n = 328) Ma et al [51] Control group (n = 120) Olinder et al [53] Sepsis (n = 100) Pajenda et al [55] Patients without AKI (n = 17) Saridaki et al [56] Severe respiratory failure (SRF) Tian et al [57] Active AOSD (n = 20)…”

Section: Halldorsdottirmentioning

confidence: 99%

Diagnostic and prognostic value of heparin-binding protein in sepsis: A systematic review and meta-analysis

Taha,

Najah,

Omar

et al. 2024

Medicine

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Background: Sepsis remains a leading cause of death worldwide. In this context, heparin-binding protein (HBP) has emerged as a possible biomarker, drawing significant attention for its diagnostic and prognostic usefulness in septic patients. Despite this advancement, the literature yields conflicting results. This study is intended to critically evaluate the diagnostic and prognostic value of HBP in critically ill septic patients. Methods: We searched multiple databases, including PubMed, SCOPUS, Web of Science, and EBSCO, to identify relevant studies on April 27, 2023. We included studies investigating sepsis or its severe outcomes that reported HBP levels and the required data to create 2 × 2 tables. We used R version 4.2.2 and R Studio to analyze the pooled diagnostic accuracy outcomes. The diagmeta package was utilized to calculate the optimum cutoff value. Results: In our meta-analysis, we incorporated 28 studies including 5508 patients. The analysis revealed that HBP has a sensitivity of 0.71 (95% CI: 0.60; 0.79) and a specificity of 0.68 (95% CI: 0.51; 0.81) in diagnosing sepsis, respectively. HBP demonstrated moderate prognostic accuracy for mortality at a cutoff value of 161.415 ng/mL, with a sensitivity and specificity of 72%, and for severe sepsis outcomes at a cutoff value of 58.907 ng/mL, with a sensitivity and specificity of 71%. Conclusion: Our findings indicate a relatively moderate diagnostic and prognostic accuracy of HBP for sepsis. Future studies are required to verify the accuracy of HBP as a biomarker for sepsis.

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Influence of the trajectory of the urine output for 24 h on the occurrence of AKI in patients with sepsis in intensive care unit

Zhang

Han

et al. 2021

J Transl Med

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Background Sepsis-associated acute kidney injury (S-AKI) is a common and life-threatening complication in hospitalized and critically ill patients. This condition is an independent cause of death. This study was performed to investigate the correlation between the trajectory of urine output within 24 h and S-AKI. Methods Patients with sepsis were studied retrospectively based on the Medical Information Mart for Intensive Care IV. Latent growth mixture modeling was used to classify the trajectory of urine output changes within 24 h of sepsis diagnosis. The outcome of this study is AKI that occurs 24 h after sepsis. Cox proportional hazard model, Fine–Gray subdistribution proportional hazard model, and doubly robust estimation method were used to explore the risk of AKI in patients with different trajectory classes. Results A total of 9869 sepsis patients were included in this study, and their 24-h urine output trajectories were divided into five classes. The Cox proportional hazard model showed that compared with class 1, the HR (95% CI) values for classes 3, 4, and 5 were 1.460 (1.137–1.875), 1.532 (1.197–1.961), and 2.232 (1.795–2.774), respectively. Competing risk model and doubly robust estimation methods reached similar results. Conclusions The trajectory of urine output within 24 h of sepsis patients has a certain impact on the occurrence of AKI. Therefore, in the early treatment of sepsis, close attention should be paid to changes in the patient's urine output to prevent the occurrence of S-AKI.

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Heparin-binding protein as a novel biomarker for sepsis-related acute kidney injury

Cited by 4 publications

References 59 publications

Hepcidin, in contrast to heparin binding protein, does not portend acute kidney injury in patients with community acquired septic shock

Hepcidin, in contrast to heparin binding protein, does not portend acute kidney injury in patients with community acquired septic shock

Diagnostic and prognostic value of heparin-binding protein in sepsis: A systematic review and meta-analysis

Influence of the trajectory of the urine output for 24 h on the occurrence of AKI in patients with sepsis in intensive care unit

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