Value of Serum Thrombomodulin as a Marker and Predictor in Patients with Sepsis-Associated Acute Kidney Injury

Van Tri Nguyen; Hong Ngoc Nguyen-Phan; That Ngoc Ton; Bui Bao Hoang

doi:10.2147/IJGM.S417410

Value of Serum Thrombomodulin as a Marker and Predictor in Patients with Sepsis-Associated Acute Kidney Injury

Int J Gen Med. 2023 Jul 10:16:2933-2941. doi: 10.2147/IJGM.S417410. eCollection 2023.

Authors

Van Tri Nguyen^{1

2}, Hong Ngoc Nguyen-Phan¹, That Ngoc Ton³, Bui Bao Hoang¹

Affiliations

¹ Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.
² Department of Anesthesiology of Hue International Medical Center, Hue Central Hospital, Hue City, Vietnam.
³ Department of Biochemistry, Hue Central Hospital, Hue City, Vietnam.

Abstract

Objective: To investigate the serum soluble thrombomodulin (sTM) concentration in patients with sepsis-associated acute kidney injury (AKI) and to determine the value of sTM in predicting AKI and mortality in sepsis patients.

Methods: This prospective observational study was conducted on 71 patients diagnosed with sepsis according to Sepsis 3 at the Intensive Care Unit, Hue Central Hospital, Vietnam, from September 2021 to February 2023.

Results: Among 71 sepsis patients, there were 38 (53.5%) AKI cases, including 16 (22.5%) cases of stage 1 AKI, 14 (19.7%) cases of stage 2 AKI, 8 (11.3%) cases of stage 3 AKI, 16 (22.5%) cases of renal replacement therapy, 28 (39.4%) cases of septic shock, and 21 (29.6%) cases of mortality within 28 days. The concentrations of lactate and IL-6 in the AKI and mortality groups were statistically significantly greater than those in the non-AKI and survival groups (p < 0.05). The serum sTM concentration was 4.33 ng/mL, the serum sTM level in the AKI group was statistically significantly higher than that in the non-AKI group (sTM [4.71 vs 2.54 ng/mL, p < 0.001]), and the serum sTM level in the mortality group was statistically significantly higher than the survival group (sTM [4.78 vs 3.87 ng/mL, p < 0.001]). The AUC of sTM for predicting AKI was 0.864; the AUCs of sTM, IL-6, SOFA, and APACHE II for predicting mortality were 0.811, 0.671, 0.816, and 0.705, respectively.

Conclusion: AKI was a prevalent complication among sepsis patients at the ICU. In the AKI and mortality groups, sTM concentration was statistically significantly higher than that in the non-AKI and survival groups. sTM was the predictor of acute kidney injury and mortality in patients with sepsis.

Keywords: acute kidney injury; sepsis; thrombomodulin.