Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury

AbstractBackground Sepsis-induced acute kidney injury (S-AKI) is a common complication in critically ill patients. Therefore, reliable biomarkers for predicting S-AKI outcomes are necessary. Serum cell-free DNA (cfDNA) is a circulating extracellular DNA fragment used as a noninvasive screening tool...

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Main Authors: Feixiang Xu, Xiao Tan, Jianli Wang, Su Lu, Hailin Ding, Mingming Xue, Yumei Chen, Sheng Wang, Jie Teng, Yiqin Shi, Zhenju Song
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2273422
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author Feixiang Xu
Xiao Tan
Jianli Wang
Su Lu
Hailin Ding
Mingming Xue
Yumei Chen
Sheng Wang
Jie Teng
Yiqin Shi
Zhenju Song
author_facet Feixiang Xu
Xiao Tan
Jianli Wang
Su Lu
Hailin Ding
Mingming Xue
Yumei Chen
Sheng Wang
Jie Teng
Yiqin Shi
Zhenju Song
author_sort Feixiang Xu
collection DOAJ
description AbstractBackground Sepsis-induced acute kidney injury (S-AKI) is a common complication in critically ill patients. Therefore, reliable biomarkers for predicting S-AKI outcomes are necessary. Serum cell-free DNA (cfDNA) is a circulating extracellular DNA fragment used as a noninvasive screening tool for many diseases, including sepsis. This study aimed to investigate the prognostic value of cfDNA in S-AKI patients and its relationship with some other parameters.Methods A total of 89 S-AKI patients admitted to the intensive care unit (ICU) from June 2021 to December 2021 were enrolled in this study. The patients were categorized into the low cfDNA group (< 855 ng/ml) and high cfDNA group (≥ 855 ng/ml) and were followed up for three months. CfDNA was extracted from serum and quantified using Quant-iT PicoGreen dsDNA Reagent.Results Overall survival was significantly lower in the high cfDNA group than in the low cfDNA group (Log-Rank p = 0.012). Univariate Cox proportional hazard model showed that cfDNA was significantly associated with all-cause mortality (HR [hazard ratio] 2.505, 95% CI [95% confidence interval] 1.184–5.298, p = 0.016). Also, serum cfDNA was a significant risk factor for all-cause mortality after adjusting for covariates (HR 2.191, 95% CI 1.017–4.721, p = 0.045). Moreover, cfDNA was positively correlated with several baseline parameters, including serum creatine, aspartate aminotransferase, alanine aminotransferase, prothrombin time, and International Normalized Ratio.Conclusion High serum cfDNA level is associated with higher mortality among the S-AKI population, indicating that cfDNA is a valuable biomarker for S-AKI prognosis.
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spelling doaj.art-709c01c338f5446e8a835a51510c54612024-04-02T01:29:28ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2023.2273422Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injuryFeixiang Xu0Xiao Tan1Jianli Wang2Su Lu3Hailin Ding4Mingming Xue5Yumei Chen6Sheng Wang7Jie Teng8Yiqin Shi9Zhenju Song10Department of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Zhongshan Hospital, Fudan University, Shanghai, ChinaAbstractBackground Sepsis-induced acute kidney injury (S-AKI) is a common complication in critically ill patients. Therefore, reliable biomarkers for predicting S-AKI outcomes are necessary. Serum cell-free DNA (cfDNA) is a circulating extracellular DNA fragment used as a noninvasive screening tool for many diseases, including sepsis. This study aimed to investigate the prognostic value of cfDNA in S-AKI patients and its relationship with some other parameters.Methods A total of 89 S-AKI patients admitted to the intensive care unit (ICU) from June 2021 to December 2021 were enrolled in this study. The patients were categorized into the low cfDNA group (< 855 ng/ml) and high cfDNA group (≥ 855 ng/ml) and were followed up for three months. CfDNA was extracted from serum and quantified using Quant-iT PicoGreen dsDNA Reagent.Results Overall survival was significantly lower in the high cfDNA group than in the low cfDNA group (Log-Rank p = 0.012). Univariate Cox proportional hazard model showed that cfDNA was significantly associated with all-cause mortality (HR [hazard ratio] 2.505, 95% CI [95% confidence interval] 1.184–5.298, p = 0.016). Also, serum cfDNA was a significant risk factor for all-cause mortality after adjusting for covariates (HR 2.191, 95% CI 1.017–4.721, p = 0.045). Moreover, cfDNA was positively correlated with several baseline parameters, including serum creatine, aspartate aminotransferase, alanine aminotransferase, prothrombin time, and International Normalized Ratio.Conclusion High serum cfDNA level is associated with higher mortality among the S-AKI population, indicating that cfDNA is a valuable biomarker for S-AKI prognosis.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2273422Biomarkersepsis-associated acute kidney injurycell-free DNAmortality
spellingShingle Feixiang Xu
Xiao Tan
Jianli Wang
Su Lu
Hailin Ding
Mingming Xue
Yumei Chen
Sheng Wang
Jie Teng
Yiqin Shi
Zhenju Song
Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury
Renal Failure
Biomarker
sepsis-associated acute kidney injury
cell-free DNA
mortality
title Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury
title_full Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury
title_fullStr Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury
title_full_unstemmed Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury
title_short Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury
title_sort cell free dna predicts all cause mortality of sepsis induced acute kidney injury
topic Biomarker
sepsis-associated acute kidney injury
cell-free DNA
mortality
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2273422
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