The effect of continuous renal replacement therapy based on kidney disease improving global outcomes organization staging on autophagy-related proteins expression and its relationship with the prognosis in the treatment of patients with acute kidney injury / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of continuous renal replacement therapy (CRRT) based on kidney disease improving global outcomes organization (KDIGO) staging on mononuclear cell microtubule-associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ), autophagy related protein 5 (ATG5) and autophagy genes Beclin-1 in the treatment of patients with acute kidney injury (AKI) and its relationship with prognosis.Methods:Eighty patients who were diagnosed with AKI and treated with CRRT in Shaoxing Central Hospital from January 2019 to December 2020 were selected as the research object. According to the KDIGO-AKI standard, they were divided into stageⅠ(24 cases), stageⅡ(26 cases) and stage Ⅲ (30 cases). The prognosis, general data, autophagy related molecular mRNA levels were compared among the three groups and multivariate Logistic regression was used to analyze the risk factors of the prognosis of patients.Results:The age, CRRT treated time, ICU stay time, mean arterial pressure, blood lactic acid and 24 hlactate clearance rate in three groups had no significant differences ( P>0.05). The levels of LC3-Ⅱ in the three group were 1.13 ± 0.11, 1.47 ± 0.23, 1.66 ± 0.19, and the levels of ATG5 in the three group were 1.24 ± 0.26, 1.48 ± 0.17, 1.62 ± 0.16, the levels of Beclin-1 in three group were 1.23 ± 0.15, 1.51 ± 0.12, 1.71 ± 0.13, there were statistical differences ( P<0.05). The 28 d survival rate and the hospital mortality rate in the three group had significant differences ( P<0.05), the patients in the stage Ⅲ group had lowest 28 d survival rate and highest hospital mortality rate. Multivariate Logistic regression analysis results showed that LC3-Ⅱ, Beclin-1 levels and AKI grading were the risk factors affecting the 28 d survival rate and the hospital mortality rate. Conclusions:Starting CRRT based on KDIGO stage in the treatment of AKI can improve the prognosis of patients, and autophagy factor LC3-Ⅱ, Beclin-1 and AKI stage are risk factors affecting the prognosis of patients.