Diagnostic and prognostic assessment value of serum interlukin-35 combined with Klotho protein in acute kidney injury with sepsis / 中国医师进修杂志

ABSTRACT

Objective:To investigate the diagnostic and prognostic assessment value of serum interlukin(IL)-35 combined with Klotho protein in acute kidney injury(AKI) with sepsis.Methods:One hundred and seventy-five patients with sepsis admitted to Affliated Dongfeng Hospital, Hubei University of Medicine from January 2017 to May 2019 were enrolled and divide into AKI group(86 cases) and non-AKI group (89 cases) according to the standard of Kidney Disease Improving Global Outcomes (KIDGO) and groups were divided based on the prognosis of AKI clinical outcome. The levels of serum creatine (Scr), serum IL-35 and Klotho protein of different groups were compared. The receiver operating characteristic curve (ROC curve) of serum IL-35, Klotho protein and IL-35 combined with Klotho protein were drawn, and the value of serum IL-35, Klotho protein and IL-35 combined with Klotho protein in the diagnosis and prognosis prediction of sepsis AKI were evaluated.Results:The level of Scr in the AKI group was higher than that in the non-AKI group [(264.43 ± 67.86) μmol/L vs. (64.76 ± 22.41) μmol/L], while the levels of IL-35 and Klotho protein were lower than those in the non-AKI group [(69.37 ± 28.15)ng/L vs. (94.74 ± 35.32) ng/L, (142.31 ± 32.55) ng/L vs. (256.23 ± 36.25) ng/L], and the differences were statistically significant ( P<0.05). In the patients that had AKI, those who were in AKI phase one, without continuous renal dialysis or whose renal functions recovered at the end point had relatively lower Scr level and higher IL-35 and Klotho protein levels, and the differences were statistically significant ( P<0.05). The area under the curve (AUC) of AKI and staged AKI predicted by IL-35 combined with Klotho protein levels were 0.918 and 0.899 respectively, and the area under the curve (AUC) of continuous renal replacement therapy needed in the AKI patients and their renal function recovery predicted by IL-35 combined with Klotho protein levels were 0.954 and 0.950 respectively, all higher than the single indicator, and the differences were statistically significant ( P<0.05). Conclusions:IL-35 and Klotho protein levels are good biomarkers in diagnosing the patients′ sepsis complicated by AKI as well as the prognosis. The combination of the two index will further improve the prediction effect.