Neutrophil activation in septic acute kidney injury : A post hoc analysis of the FINNAKI study

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Törnblom , S , Nisula , S , Vaara , S T , Poukkanen , M , Andersson , S , Pettilä , V & Pesonen , E 2019 , ' Neutrophil activation in septic acute kidney injury : A post hoc analysis of the FINNAKI study ' , Acta Anaesthesiologica Scandinavica , vol. 63 , no. 10 , pp. 1390-1397 . https://doi.org/10.1111/aas.13451

Title: Neutrophil activation in septic acute kidney injury : A post hoc analysis of the FINNAKI study
Author: Törnblom, Sanna; Nisula, Sara; Vaara, Suvi T.; Poukkanen, Meri; Andersson, Sture; Pettilä, Ville; Pesonen, Eero
Other contributor: University of Helsinki, Anestesiologian yksikkö
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine







Date: 2019-11
Language: eng
Number of pages: 8
Belongs to series: Acta Anaesthesiologica Scandinavica
ISSN: 0001-5172
DOI: https://doi.org/10.1111/aas.13451
URI: http://hdl.handle.net/10138/312955
Abstract: Background Inflammation, reflected by high plasma interleukin-6 concentration, is associated with acute kidney injury (AKI) in septic patients. Neutrophil activation has pathophysiological significance in experimental septic AKI. We hypothesized that neutrophil activation is associated with AKI in critically ill sepsis patients. Methods We measured plasma (n = 182) and urine (n = 118) activin A (a rapidly released cytosolic neutrophil protein), interleukin-8 (a chemotactic factor for neutrophils), myeloperoxidase (a neutrophil biomarker released in tissues), and interleukin-6 on intensive care unit admission (plasma and urine) and 24 hours later (plasma) in sepsis patients manifesting their first organ dysfunction between 24 hours preceding admission and the second calendar day in intensive care unit. AKI was defined by the Kidney Disease: Improving Global Outcomes criteria. Results Plasma admission interleukin-8 (240 [60-971] vs 50 [19-164] pg/mL, P <.001) and activin A (845 [554-1895] vs 469 [285-862] pg/mL, P <.001) were but myeloperoxidase (169 [111-300] vs 144 [88-215] ng/mL, P = .059) was not higher among patients with AKI compared with those without. Urine admission interleukin-8 (50.4 [19.8-145.3] vs 9.5 [2.7-28.7] ng/mL, P <.001) and myeloperoxidase (7.7 [1.5-12.6] vs 1.9 [0.4-6.9] ng/mL, P <.001) were but activin A (9.7 [1.4-42.6] vs 4.0 [0.0-33.0] ng/mL, P = .064) was not higher in AKI than non-AKI patients. Urine myeloperoxidase correlated with urine interleukin-8 (R = .627, P <.001) but not with plasma myeloperoxidase (R = .131, P = .158). Conclusion Interleukin-8 in plasma and urine was associated with septic AKI. Elevated plasma activin A indicates intravascular neutrophil activation in septic AKI. Concomitant plasma and urine myeloperoxidase measurements suggest neutrophil accumulation into injured kidneys.
Subject: activin A
acute kidney injury
critical illness
intensive care
interleukin-6
interleukin-8
myeloperoxidase
sepsis
ACUTE-RENAL-FAILURE
HEPARIN-BINDING PROTEIN
NECROSIS-FACTOR-ALPHA
ACTIVIN-A RELEASE
SEPSIS
SERUM
INFLAMMATION
FOLLISTATIN
MORTALITY
ENDOTOXEMIA
3126 Surgery, anesthesiology, intensive care, radiology
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