Novel Damage Biomarkers of Sepsis-Related Acute Kidney Injury

Dániel Ragán; Zoltán Horváth-Szalai; Balázs Szirmay; Diána Mühl

Novel Damage Biomarkers of Sepsis-Related Acute Kidney Injury

EJIFCC. 2022 Apr 11;33(1):11-22. eCollection 2022 Apr.

Authors

Dániel Ragán^{1

2}, Zoltán Horváth-Szalai^{1

3}, Balázs Szirmay¹, Diána Mühl²

Affiliations

¹ Department of Laboratory Medicine, Medical School, University of Pécs, Hungary.
² Department of Anesthesiology and Intensive Therapy, Medical School, University of Pécs, Hungary.
³ János Szentágothai Research Center, University of Pécs, Hungary.

PMID: 35645693
PMCID: PMC9092722

Abstract

Sepsis-related acute kidney injury (AKI) is one of the most common complications of sepsis at the intensive care unit (ICU) with more adverse mortality rates. The early diagnosis and reliable monitoring of sepsis-related AKI are essential in achieving a favorable outcome. Novel serum and urinary biomarkers could yield valuable information during this process. Regarding the widely used Kidney Disease Improving Global Outcomes (KDIGO) classifications, the diagnosis of AKI is still based on the increase of serum creatinine levels and the decrease of urine output; however, these parameters have limitations in reflecting the extent of kidney damage, therefore more sensitive and specific laboratory biomarkers are needed for the early diagnosis and prognosis of sepsis-related AKI. Regarding this, several serum parameters are discussed in this review including presepsin and the most important actin scavenger proteins (gelsolin, Gc-globulin) while other urinary markers are also examined including cell cycle arrest biomarkers, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1), Cystatin C and actin. Novel biomarkers of sepsis-related AKI could facilitate the early diagnosis and monitoring of sepsis-related AKI.

Keywords: Sepsis-3; acute kidney injury; gelsolin; novel biomarker; presepsin; urinary Gc-globulin; urinary actin.