The diagnostic and prognostic value of heme oxygenase 1 in sepsis-induced acute kidney injury: a cross-sectional observational study

Abstract

Background Sepsis patients suffer from severe inflammatory and poor prognosis. Local inflammation resulted from sepsis is found to trigger organ injury, such as acute kidney injury (AKI). We conducted a cross-sectional observational study to examine the diagnostic and prognostic role of serum heme oxygenase 1 (HO-1) on sepsis-induced AKI. Methods The 83 enrolled patients were initially divided into two groups with no AKI (NAKI) and sepsis-induced AKI group (SAKI) based on whether had AKI. Then the patients were concretely divided into four groups: septic shock and AKI group (SS+AKI group), sepsis-induced AKI group (S+AKI group), septic shock group (SS group), and sepsis group (S group. The venous blood was sampled within 24 hours after diagnosis of sepsis. We detected the serum HO-1 and laboratory indicators by enzyme-linked immunosorbent assay. The 28-day survival status was observed between the HO-1 high- and low-level patients grouped by the median of HO-1 concentration 41.33U/L. Results We found that there were statistically significant results of SOFA score and admission time between SAKI and NAKI group (p<0.05). The level of HO-1 in SAKI group was obviously elevated as compared with NAKI group (p<0.05). It was remarkable to show that HO-1 level was remarkably higher in SS+AKI group than that in other three groups (p<0.05). In All groups, HO-1 positively correlates with SOFA score, Scr, Hb, APTT, Urea, and TnI (p<0.05). In SS+AKI group, HO-1 was positively associated with SOFA score, Scr, AKI stage, γ-GT, and FDP (p<0.05). In S+AKI, HO-1 level was positively related to the level of Scr, AKI stage, and ALP (p<0.05). In SS group, SOFA score was in negative correlation to HO-1 (p<0.05). The AUC of HO-1 and serum creatinine was 0.824 (95% CI: 0.703-0.944) and 0.778 (95% CI: 0.658-0.919) separately. The AUC of combined with HO-1 and serum creatinine was 0.864 (95% CI: 0.761-0.968). The survival analysis showed that sepsis patients with high HO-1 level had a higher mortality rate compared with patients with low HO-1 expression. Conclusions The findings from this study make contributions to clinical value of HO-1, suggesting that HO-1 plays a diagnostic and prognostic role in sepsis-induced AKI.