Journal of Hebei Medical University ›› 2023, Vol. 44 ›› Issue (11): 1295-1300.doi: 10.3969/j.issn.1007-3205.2023.11.010

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Significance of DKK3 in early diagnosis of sepsis-associated acute renal injury

  

  1. 1.Department of General Practice, General Hospital of North China Petroleum Administration, Hebei 
    Province, Renqiu 062552, China; 2.Department of Emergency Medicine, General Hospital of North 
    China Petroleum Administration, Hebei Province, Renqiu 062552, China

  • Online:2023-11-25 Published:2023-12-05

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Abstract: Objective To prospectively explore the predictive value of Dickkopf WNT signaling pathway inhibitor 3 (DKK3) for disease occurrence and outcome in patients with sepsis-associated acute kidney injury (SAKI). 
Methods The inpatients who were treated in the intensive care unit (ICU) in General Hospital of North China Petroleum Administration were divided into different groups. The clinical laboratory data of the enrolled patients were collected, and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), and the sequential organ failure assessment (SOFA) and kidney disease: improving global outcomes (KDIGO) stage were used for risk assessment of enrolled patients. SPSS 21.0 and GraphPad Prism 8.0.1 were used for statistical analysis, and significant correlation factors were compared and analyzed between groups. Receiver operating characteristic (ROC) curve was used to analyze the evaluation performance of the prediction model, and P＜0.05 was considered statistically significant. 
Results A total of 80 patients with sepsis were included in this study, including 31 (38.75%) with SAKI, and 49 (61.25%) with sepsis but without acute kidney injury (AKI). The median value of DKK3 in patients with SAKI was significantly higher than that in patients with sepsis but without AKI ［843 (765.0, 998.0), 76 (40.5, 348.0); P＜0.05］. The median value of DKK3 increased with the increase of KDIGO stage in SAKI patients (P＜0.05). ROC showed that DKK3 had the optimal evaluation efficacy on AKI in patients with sepsis (AUC=0.978, P＜0.05), and compared with DKK3 combined with serum creatinine (Scr), DKK3 combined with neutrophil gelatinase-associated lipocalin (NGAL) was more effective in treating AKI in patients with sepsis (AUC=0.989, P＜0.05). In predicting disease outcome in patients with SAKI, compared with DKK3 alone, DKK3 combined with NGAL was more effective in evaluating chronic kidney disease (CKD) in SAKI patients (AUC=0.979, P＜0.05). 
Conclusion The increase of DKK3 is associated with the occurrence of AKI and the severity of AKI in patients with sepsis, and the combination of DKK3 and NGAL can better identify high risk group in early stage by evaluating the occurrence of AKI and disease progression in patients with sepsis.


Key words: kidney diseases, Dickkopf-associated protein 3, lipocalins