氧化应激和抗氧化能力与脓毒症急性肾损伤患者肾脏预后的动态关系：一项横断面和随访研究

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-08-05 DOI:10.1016/j.clnu.2025.07.031

Tsai-Jung Wang , Wei-Ru Lin , Shih-Chien Huang , Cheng-Hsu Chen , Chen-Yu Wang , Yi-Chia Huang

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引用次数: 0

摘要

背景,目的脓毒症经常导致急性肾损伤（AKI），这是危重患者的常见并发症。了解脓毒症患者，特别是AKI患者的氧化应激和抗氧化能力的动态变化，可以改善对肾脏预后的监测和预测。本研究旨在评估合并和不合并AKI的脓毒症患者在进入重症监护病房（ICU）时和一周后氧化应激和抗氧化能力的波动。此外，它还试图研究特异性氧化应激和抗氧化标志物与肾脏预后之间的潜在相关性。方法对124例脓毒症危重症患者进行横断面随访研究。根据患者入ICU时是否存在AKI进行分组。收集患者入院第1天和第7天的流行病学、临床资料及氧化应激和抗氧化能力生化指标。结果结果显示，AKI患者在两个评估日的血浆中晚期氧化蛋白产物（AOPP）浓度均显著升高。抗氧化能力，包括血浆谷胱甘肽（GSH）、谷胱甘肽过氧化物酶（GPx）和超氧化物歧化酶，在两组之间观察到显著差异。在AKI患者中，血浆氧化应激和抗氧化能力表现出密切的关系。具体而言，第1天血浆GSH浓度与14天和28天内主要肾脏不良事件（MAKE14和MAKE28）的发生率增加相关，而第7天血浆GPx活性升高与MAKE14和MAKE28的发生率降低相关。结论重症脓毒症患者入院第1天监测血浆GSH浓度，结合第7天血浆GPx活性评估，可作为预测重症脓毒症患者肾脏预后的关键指标。

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Dynamics of oxidative stress and antioxidant capacity in relation to renal outcomes in septic patients with acute kidney injury: A cross-sectional and follow-up study

Background & aims

Sepsis frequently results in acute kidney injury (AKI), a common complication among critically ill patients. Understanding the dynamics of oxidative stress and antioxidant capacity in septic patients, particularly those with AKI, could improve the monitoring and prediction of renal outcomes. This study aimed to evaluate fluctuations in oxidative stress and antioxidant capacities in septic patients with and without AKI at the time of admission to the intensive care unit (ICU) and one week later. In addition, it sought to investigate the potential correlation between specific oxidative stress and antioxidant markers and renal outcomes.

Methods

A cross-sectional and follow-up study was conducted, involving 124 critically ill septic patients. The patients were divided into groups according to the presence of AKI at admission to the ICU. Epidemiological, clinical data, and biochemical measurements of oxidative stress and antioxidant capacity were collected on days 1 and 7 of ICU admission.

Results

The results indicated that plasma concentrations of advanced oxidation protein products (AOPP) were significantly higher in patients with AKI on both evaluation days. Notable differences in antioxidant capacities, including plasma glutathione (GSH), glutathione peroxidase (GPx), and superoxide dismutase, were observed between the two groups. In patients with AKI, plasma oxidative stress and antioxidant capacity demonstrated a close relationship. Specifically, plasma GSH concentrations on day 1 were correlated with increased odds of major adverse kidney events within 14 and 28 days (MAKE14 and MAKE28), while elevated plasma GPx activities on day 7 were associated with reduced odds of MAKE14 and MAKE28.

Conclusions

Monitoring plasma GSH concentrations on the 1st day of ICU admission, in conjunction with the evaluation of plasma GPx activities on the 7th day, may serve as pivotal indicators for predicting renal outcomes in critically septic patients.

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.