Role of plasma suPAR, sTNFR1, and sTNFR2 levels in risk stratification and outcome prediction of complicated acute kidney injury in elderly patients with coronavirus disease 2019

IF 3.9
Fang Li , Xue Tian , Lu Wang , Ling-Pei Wu , Xiao Liu , Hong-Ying Peng
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引用次数: 0

Abstract

Objective

The aim of this study is to investigate the early prognostic efficacy of plasma soluble urokinase-type plasminogen activator receptor (suPAR), soluble tumor necrosis factor receptor 1 (sTNFR1), and soluble tumor necrosis factor receptor 2 (sTNFR2) in complicated acute kidney injury (AKI) in patients with coronavirus disease 2019 (COVID-19), and to analyze the relevant factors contributing to complicated AKI in these patients.

Methods

Patients with COVID-19 hospitalized at the Affiliated Baiyun Hospital of Guizhou Medical University from March 2022 to March 2024 were selected as study participants. A total of 589 patients met the inclusion and exclusion criteria, 68 patients complicated with AKI were classified as AKI group, and the remaining 521 cases were divided into proportion sampling method and randomly selected 200 samples, which were classified as non-AKI group. Additionally, 50 healthy controls were enrolled as the control group. Logistic regression analysis was conducted to identify the relevant factors associated with complicated AKI in patients with COVID-19. Receiver operating characteristic (ROC) curves were plotted to evaluate the prognostic efficacy of plasma suPAR, sTNFR1, and sTNFR2 indicators for complicated AKI in patients with COVID-19.

Results

Among the patients with COVID-19 in the AKI group, 43 were males (63.20 %), with a median age of 79.00 (interquartile range: 75.00, 83.00) years, while the non-AKI group comprised 83 males (41.50 %), with a median age of 73.00 (interquartile range: 60.00, 80.75) years. Comparison of the sex and age between the two groups indicated that males and elderly patients had increased risks of complicated AKI (P < 0.05). Plasma levels of suPAR, sTNFR1, and sTNFR2 in the AKI group were significantly higher than those in the non-AKI group (P < 0.05). Logistic regression analysis indicated that suPAR and sTNFR2 were independent factors influencing complicated AKI in patients with COVID-19 (P < 0.05). The ROC curve for a single indicator showed that suPAR had the highest prognostic efficacy for complicated AKI, with an area under the curve (AUC) of 0.813, a sensitivity of 79.4 %, and a specificity of 74.0 %. The combined use of suPAR and sTNFR2 for risk assessment yielded the highest AUC of 0.838, with a sensitivity of 66.2 % and a specificity of 87.5 %. The combined risk assessment using all three indicators (suPAR, sTNFR1, and sTNFR2) had an AUC of 0.837, with a sensitivity of 64.7 % and a specificity of 89.0 %.

Conclusion

Elderly patients had increased risks of complicated AKI. Indicators such as suPAR, sTNFR1, and sTNFR2 can assist in assessing the risk in patients with COVID-19 complicated AKI, with suPAR demonstrating the highest prognostic efficacy as a single indicator. The combined detection of suPAR, sTNFR1, and sTNFR2 offers greater prognostic value than using any single indicator.
血浆 suPAR、sTNFR1 和 sTNFR2 水平在冠状病毒病老年患者并发急性肾损伤的风险分层和结果预测中的作用 2019.
研究目的本研究旨在探讨血浆可溶性尿激酶型纤溶酶原激活物受体(suPAR)、可溶性肿瘤坏死因子受体1(sTNFR1)和可溶性肿瘤坏死因子受体2(sTNFR2)在2019年冠状病毒病(COVID-19)患者并发急性肾损伤(AKI)中的早期预后效果,并分析导致这些患者并发AKI的相关因素:选取2022年3月至2024年3月在贵州医科大学附属白云医院住院治疗的COVID-19患者作为研究对象。共有 589 例患者符合纳入和排除标准,其中 68 例并发 AKI 患者被划分为 AKI 组,其余 521 例采用比例抽样法随机抽取 200 例样本,被划分为非 AKI 组。此外,还招募了 50 名健康对照者作为对照组。为确定COVID-19患者复杂性AKI的相关因素,进行了逻辑回归分析。绘制了接收者操作特征曲线(ROC),以评估血浆 suPAR、sTNFR1 和 sTNFR2 指标对 COVID-19 患者复杂性 AKI 的预后效果:AKI组COVID-19患者中男性43人(占63.20%),中位年龄79.00(四分位距:75.00,83.00)岁;非AKI组男性83人(占41.50%),中位年龄73.00(四分位距:60.00,80.75)岁。对两组患者的性别和年龄进行比较后发现,男性和老年患者发生复杂性 AKI 的风险更高(P 结论:男性和老年患者发生复杂性 AKI 的风险更高):老年患者发生复杂性 AKI 的风险更高。suPAR、sTNFR1 和 sTNFR2 等指标可帮助评估 COVID-19 并发 AKI 患者的风险,其中 suPAR 作为单一指标的预后效力最高。联合检测 suPAR、sTNFR1 和 sTNFR2 比使用任何单一指标都更有预后价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Experimental gerontology
Experimental gerontology Ageing, Biochemistry, Geriatrics and Gerontology
CiteScore
6.70
自引率
0.00%
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0
审稿时长
66 days
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