The value of serum miR-320 expression in predicting the prognosis of sepsis children complicated with acute kidney injury / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the prognostic value of serum levels of miR-320 in sepsis children complicated with acute kidney injury (AKI).Methods:A total of 158 sepsis children with complicated with AKI who were admitted to Hainan Women and Children′s Medical Center from January 2017 to June 2019 were divided into survival group (105 cases) and death group (53 cases) according to their 28-day survival.Serum levels of miR-320, neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and serum creatinine (Scr) were detected in the two groups.Multivariate Logistic regression was used to analyze the risk factors of death in children with sepsis complicated with AKI.The receiver operating characteristic curve (ROC) was drawn to analyze the value of serum levels of miR-320, NGAL, KIM-1 and Scr in predicting the death of children with sepsis complicated with AKI.The correlation between serum levels of miR-320 and NGAL, KIM-1 and Scr was analyzed using Pearson correlation analysis. Results:The serum levels of miR-320 (1.28±0.47 vs. 0.54±0.12), NGAL [(537.40±48.26) mg/L vs. (285.60±29.40) mg/L], KIM-1 [(26.80±5.72) μg/ L vs. (16.35±3.17) μg/L] and Scr[(573.70±105.46) μmol/L vs. (390.64±74.38) μmol/L] in the death group were significantly higher than those in the survival group (all P<0.001). Multivariate Logistic regression analysis showed that serum levels of miR-320 ( OR=2.280, 95% CI 1.483-4.380), NGAL ( OR=2.753, 95% CI 1.826-5.227), KIM-1 ( OR=1.985, 95% CI 1.274-3.518) and Scr ( OR=1.714, 95% CI 1.105-2.986) were independent risk factors for death in sepsis children with AKI (all P<0.001). ROC curve analysis showed that the area under the curve (0.952, 95% CI 0.894-0.990) of serum miR-320, NGAL, KIM-1 and Scr levels combined to predict the death of children with sepsis and AKI was the largest, with a high sensitivity and specificity of 95.8% and 90.6%.Correlation analysis showed that the expression level of serum miR-320 in the death group was positively correlated with NGAL, KIM-1 and Scr ( r=0.874, 0.830, 0.702, all P<0.01). Conclusions:Serum levels of miR-320 are significantly increased in sepsis children with AKI, which is an independent risk factor for death in sepsis children with AKI.The combination of NGAL, KIM-1 and Scr levels has important value in predicting the prognosis of children with AKI.