Accuracy and sensitivity of high mobility group box 1 (HMGB1) in diagnosis of acute kidney injury caused by sepsis and relevance to prognosis

Objective: The diagnostic value of high mobility group box 1 (HMGB1) levels in patients with acute kidney injury (AKI) caused by sepsis and its relationship with disease prognosis were investigated to improve patient survival. Methods: A total of 120 patients diagnosed with sepsis by comprehensive clinical examination were selected as the research subjects. According to the presence or absence of concurrent AKI, all patients were divided into SIAKI (50 cases with concurrent AKI) and N-AKI groups (70 cases without concurrent AKI). Sixty normal people receiving a physical examination in our hospital during the same period were divided into the control group. The diagnostic efficacy and the influences of HMGB1 on prognosis were assessed. Results: HMGB1 levels in the serum and urine of the control group (3.43 +/- 0.73 pg/mL, 343.13 +/- 51.03 pg/mL) were both lower than those of the SIAKI (14.76 +/- 2.44 pg/mL, 1109.76 +/- 225.66 pg/mL) and N-AKI groups (7.99 +/- 1.84 pg/mL, 890.54 +/- 97.76 pg/mL) (P < 0.05). HMGB1 in the serum of the SIAKI group was higher than that of the N-AKI group (P < 0.05). The sensitivity (88%), specificity (87%), accuracy (88%), and area under the curve (AUC) (0.891) of the joint diagnosis of HMGB1 in blood and urine were superior to the diagnostic effects of HMGB1 in serum (70%, 70%, 70%, and 0.701) and HMGB1 in urine (59%, 57%, 58%, and 0.677) (P < 0.05). The proportion of HMGB1 in the nonsurvivors was higher than that in the survivors (85%) and was obviously higher than that in the survivors (15%) (P < 0.05). Conclusion: As a diagnostic marker of sepsis complicated with AKI, HMGB1 in serum and urine showed good application value. Serum HMGB1 could be used to assess disease prognosis with good clinical promotion.