THE VALUE OF PERIPHERAL BLOOD NLRP3, PNGAL AND PPENK IN EVALUATING THE PROGNOSIS OF SEPSIS PATIENTS WITH ACUTE RENAL INJURY

Yutong Liu¹, Lin Bu¹, Yali Chao¹, Houqing Wang^{2, *}

¹Department of Intensive Care Unit, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China - ²Department of Emergency, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China

Objective: To explore the value of peripheral blood NLRP3, pngal and PPENK in evaluating the prognosis of sepsis patients with acute renal injury, and to provide reference for clinical diagnosis and treatment. 

Methods: 168 sepsis patients admitted to our hospital from July 2020 to June 2022 were collected. According to whether the patients were complicated with AKI, the subjects were divided into AKI group (n=92) and non AKI group (n=76). The AKI group was further divided into survival group (n=52) and death group (n=35) according to the prognosis of the patients. Peripheral blood NLRP3 was detected by ELISA method; Double antibody sandwich enzyme-linked immunosorbent assay was used to detect the levels of PENK and pNGAl, and to compare the differences of the above indexes among the groups. Multivariate logistic regression was used to analyze the independent risk factors for the prognosis of sepsis with acute renal injury. ROC curve was used to analyze the prognostic value of NLRP3, pNGAL and PPENK in peripheral blood in patients with sepsis and acute renal injury. 

Results: the levels of NLRP3, pNGAL and PPENK in peripheral blood of AKI group were significantly higher than those of non AKI group (P<0.05). The levels of NLRP3, pNGAL and PPENK in the peripheral blood of patients in the death group were significantly higher than those in the survival group (P<0.05). Multivariate logistic regression analysis showed that NLRP3, pNGAL and PPENK in peripheral blood were independent risk factors for poor prognosis in patients with sepsis and AKI. ROC curve analysis showed that the AUC of NLRP3, pNGAL, PPENK and combined evaluation of prognosis of sepsis patients with AKI were 0.768, 0.728, 0.675 and 0.916, respectively. 

Conclusion: the detection of NLRP3, pNGAL and PPENK in peripheral blood alone or in combination has clinical value in evaluating the prognosis of sepsis patients with acute renal injury, and can be used for clinical promotion.