Erythrocyte superoxide dismutase as a biomarker of septic acute kidney injury

被引：22

作者：

Costa, Nara Aline ^{[1
]}

Gut, Ana Lucia ^{[1
]}

Azevedo, Paula Schmidt ^{[1
]}

Tanni, Suzana Erico ^{[1
]}

Cunha, Natalia Baraldi ^{[1
]}

Magalhaes, Eloa Siqueira ^{[1
]}

Silva, Graziela Biude ^{[2
]}

Polegato, Bertha Furlan ^{[1
]}

Mamede Zornoff, Leonardo Antonio ^{[1
]}

Rupp de Paiva, Sergio Alberto ^{[1
]}

Balbi, Andre Luis ^{[1
]}

Ponce, Daniela ^{[1
]}

Minicucci, Marcos Ferreira ^{[1
]}

机构：

[1] UNESP Univ Estadual Paulista, Botucatu Med Sch, Dept Internal Med, Rubiao Jr S-N, BR-18618970 Botucatu, SP, Brazil

[2] Univ Sao Paulo, Fac Pharmaceut Sci, Dept Food & Expt Nutr, Sao Paulo, SP, Brazil

来源：

ANNALS OF INTENSIVE CARE | 2016年 / 6卷

基金：

巴西圣保罗研究基金会;

关键词：

Superoxide dismutase; Acute kidney injury; Sepsis; Oxidative stress; ACUTE-RENAL-FAILURE; OXIDATIVE STRESS; SERUM CREATININE; MALONDIALDEHYDE; CLASSIFICATION; RISK;

D O I：

10.1186/s13613-016-0198-5

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Oxidative stress is a key feature of sepsis and could be a common pathophysiological pathway between septic shock and acute kidney injury (AKI) Our objective was to evaluate the erythrocyte superoxide dismutase (SOD1) activity as predictor of AKI in patients with septic shock. Methods: This is a prospective observational study that evaluated 175 consecutive patients over the age of 18 years with septic shock upon intensive care unit (ICU) admission. However, 43 patients were excluded (27 due to AKI at ICU admission). Thus, 132 patients were enrolled in the study. At the time of the patients' enrollment, demographic information was recorded. Blood samples were taken within the first 24 h of the patient's admission to determine the erythrocyte SOD1 activity. All patients were followed throughout the ICU stay, and the development of AKI was evaluated. In addition, we also evaluated 17 control subjects. Results: The mean age of patients with septic shock was 63.2 +/- 15.7 years, 53 % were male and the median ICU stay was 8 days (4-16). Approximately 50.7 % developed AKI during the ICU stay. The median erythrocyte SOD1 activity was 2.92 (2.19-3.92) U/mg Hb. When compared to control subjects, septic shock patients had a higher serum malondialdehyde concentration and lower erythrocyte SOD1 activity. In univariate analysis, erythrocyte SOD1 activity was lower in patients who developed AKI. The ROC curve analysis revealed that lower erythrocyte SOD1 activity was associated with AKI development (AUC 0.686; CI 95 % 0.595-0.777; p < 0.001) at the cutoff of < 3.32 U/mg Hb. In the logistic regression models, SOD1 activity higher than 3.32 U/mg Hb was associated with protection of AKI development when adjusted by hemoglobin, phosphorus and APACHE II score (OR 0.309; CI 95 % 0.137-0.695; p = 0.005) and when adjusted by age, gender, chronic kidney disease, admission category (medical or surgery) and APACHE II score (OR 0.129; CI 95 % 0.033-0.508; p = 0.003). Conclusions: In conclusion, our data suggest that erythrocyte SOD1 activity could play a role as an early marker of septic AKI and could be seen as a new research avenue in the field of biomarker in AKI. However, our study did not show a strong correlation between SOD activity and AKI. Nevertheless, these original data do warrant further research in order to confirm or not this hypothesis.

引用

页数：8

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