Plasma neutrophil extracellular traps in patients with sepsis-induced acute kidney injury serve as a new biomarker to predict 28-day survival outcomes of disease

Abstract

BackgroundThere is currently no accurate, readily available, or validated biomarker for assessing disease severity and survival outcomes in sepsis-induced acute kidney injury (SAKI), which limits the ability to conduct effective therapeutic interventions. The neutrophil extracellular traps (NETs) may be involved in the pathophysiology of SAKI. The present study investigated the predictive value of plasma NETs for the survival outcome of patients with SAKI.MethodsThis observational study included 136 SAKI patients, all of whom underwent a 28-day follow-up. According to the follow-up records, SAKI patients were divided into two groups: the non-survivor group (60 subjects) and the survivor group (76 subjects). Blood samples were collected after the diagnosis of AKI to measure three NET markers and 12 inflammatory indices. Correlation analysis, logistic regression analysis, receiver operating characteristic curve analysis, and survival analysis were performed.ResultsCompared to survivors, non-survivors among SAKI patients exhibited significantly higher levels of three plasma NET markers (all p < 0.001). Meanwhile, in SAKI patients, plasma levels of NET markers were significantly associated with serum levels of inflammatory indices. Additionally, serum interleukin (IL)-2, IL-8, IL-10, and tumor necrosis factor-alpha showed an interactive effect with plasma NET markers on the survival of SAKI patients. Furthermore, the combination of three plasma NET markers could identify SAKI patients with a poor 28-day survival with better accuracy (area under the curve = 0.857). Finally, plasma NET markers may independently predict the 28-day survival in SAKI patients.ConclusionPlasma NET markers were elevated in SAKI patients with poor outcomes and served as biomarkers for predicting 28-day survival in SAKI patients.