Authors

Duan Jiang#, Aojie Liu, Wei Ling

Departments

Department of Pediatrics, Renmin Hospital Wuhan University, Wuhan, PR China

Abstract

Objective: To investigate the value of high mobility group box 1 (HMGB1) in the diagnosis of sepsis-induced acute kidney injury and its correlation with prognosis. 

Methods: Seventy-eight patients with AKI admitted to the intensive care unit of our hospital from October 2016 to October 2018 were selected for observation groups. According to the prognosis, the patients were divided into the death group (31 cases) and the survival group (47 cases). Fifty healthy people with normal renal function were selected as the control group. General data of all subjects were collected, and ELISA was used to detect changes in serum HMGB1 levels at 1, 3, 5, 7, 14 and 28 days after admission. Spearman correlation was used to analyse the correlation between serum HMGB1 and clinical indicators of AKI patients. The clinical value of HMGB1 in the prognosis evaluation of patients with AKI was analysed by ROC curve. 

Results: In the observation group, the WBC, CRP and renal function indexes Scr, BUN, renal tubular injury index, urine NAG enzyme, α1 MG, and liver function indicators TBIL, ALT and AST were significantly higher than in the control group (P<0.05). The coagulation parameters ALB and PLT were significantly lower than in the control group (P<0.05). The serum HMGB1 level in the observation group was significantly higher than in the control group (P<0.05). The serum HMGB1 level in the death group was significantly higher than in the survival group (P<0.05). Spearman correlation analysis showed that serum HMGB1 was positively correlated with Scr, BUN, WBC, CRP and α1 MG, and the difference was statistically significant (P<0.05). Serum HMGB1 was significantly negatively correlated with PLT and ALB, and the difference was statistically significant (P<0.05). Serum HMGB1 levels in the observation group were significantly higher than in the survival group at 14 and 28 days after injury (P<0.05). ROC curve analysis showed that the area under the prognosis curve of serum HMGB1 in patients with AKI was 0.857 (95% CI: 0.737~0.977, P<0.001). With 2.72 ng/mL as the best cut-off point, the sensitivity was 81.72%, and the specificity was 86.63%. 

Conclusions: There was a significant high level of HMGB1 in the serum of patients with AKI caused by sepsis, which plays a role in the development of AKI as a late inflammatory mediator. HMGB1 has a certain clinical value in evaluating the prognosis of patients with AKI. Dynamic detection of its level is helpful for monitoring sepsis and prognosis. 

Keywords

HMGB, sepsis, acute kidney injury, accuracy, sensitivity, prognosis.

DOI:

10.19193/0393-6384_2020_3_315