Heparin-binding protein as a new biomarker for acute kidney injury related to sepsis
DOI:
https://doi.org/10.18203/2349-3933.ijam20251933Keywords:
Sepsis, Acute kidney injury, Early detection, Heparin-binding proteinAbstract
Background: In emergency settings, physicians frequently encounter critically ill patients with acute kidney injury (AKI). This severe organ dysfunction leads to high morbidity and mortality, even post-discharge. To determine the association between Heparin-binding protein (HBP) and sepsis-associated AKI, facilitating early AKI prediction and intervention.
Methods: A cross-sectional prospective observational comparative study was conducted at K.P.S PG Institute of Medicine, Kanpur, from June 2023 to July 2024. Patients aged 18 years and older, suspected of sepsis, were enrolled and investigated for sepsis and AKI, along with serum heparin-binding protein.
Results: Baseline HBP levels were 5.222 (SD 3.046) in the non-AKI group and 11.979 (SD 5.972) in the AKI group. An optimum HBP cut-off >8.28 was determined. HBP levels progressively increased with AKI severity: Stage I (7.392), Stage II (10.842), and Stage III (19.623). The findings were statistically significant (F=51.854, p<0.001).
Conclusion: Sepsis-associated AKI patients had elevated HBP levels. The baseline cut-off of 8.28 aids in AKI detection.
Metrics
References
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-10. DOI: https://doi.org/10.1001/jama.2016.0287
Alseiari M, Meyer KB, Wong JB. Evidence underlying KDIGO (kidney disease: Improving Global Outcomes) guideline recommendations: a systematic review. American J Kidney Dis. 2016;67(3):417-22. DOI: https://doi.org/10.1053/j.ajkd.2015.09.016
Hoste EA, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN, Edipidis K, Forni LG, Gomersall CD, Govil D, Honoré PM. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Int Care Med. 2015;41:1411-23. DOI: https://doi.org/10.1007/s00134-015-3934-7
Pajenda S, Ilhan-Mutlu A, Preusser M, Roka S, Druml W, Wagner L. NephroCheck data compared to serum creatinine in various clinical settings. BMC Nephrol. 2015;16:1-7.
Tapper H, Karlsson A, Mörgelin M, Flodgaard H, Herwald H. Secretion of heparin-binding protein from human neutrophils is determined by its localization in azurophilic granules and secretory vesicles. Blood, J Am Soc Hematol. 2002;99(5):1785-93. DOI: https://doi.org/10.1182/blood.V99.5.1785
Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function—measured and estimated glomerular filtration rate. New England J Med. 2006;354(23):2473-83. DOI: https://doi.org/10.1056/NEJMra054415
Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Am Soc Nephrol. 2010;5(6):1003-9. DOI: https://doi.org/10.2215/CJN.06870909
Gordon AC, Lagan AL, Aganna E, Cheung L, Peters CJ, McDermott MF, et al. TNF and TNFR polymorphisms in severe sepsis and septic shock: a prospective multicentre study. Genes Immun. 2004;5(8):631-40. DOI: https://doi.org/10.1038/sj.gene.6364136
Liu F, Yang H, Chen H, Zhang M, Ma Q. High expression of neutrophil gelatinase-associated lipocalin (NGAL) in the kidney proximal tubules of diabetic rats. Adv Med Sci. 2015;60(1):133-8. DOI: https://doi.org/10.1016/j.advms.2015.01.001
Al Jaberi S, Cohen A, D’Souza C, Abdulrazzaq YM, Ojha S, Bastaki S. Lipocalin-2: Structure, function, distribution and role in metabolic disorders. Biomed Pharmaco. 2021;142:112002. DOI: https://doi.org/10.1016/j.biopha.2021.112002
Latouche C, El Moghrabi S, Messaoudi S, Nguyen DCA. Neutrophil gelatinase-associated lipocalin is a novel mineralocorticoid target in the cardiovascular system. Hypert. 2012;59(5):966-72. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.111.187872
Pajenda S, Ilhan-Mutlu A, Preusser M, Roka S, Druml W, Wagner L. NephroCheck data compared to serum creatinine in various clinical settings. BMC Nephrol. 2015;16:1-7. DOI: https://doi.org/10.1186/s12882-015-0203-5
Linder A, Arnold R, Zindovic M, Zindovic I, Lange-Jendeberg A, Paulsson M, et al. Heparin-binding protein improves prediction of severe sepsis in the emergency department. Critical Care. 2013;17:1-59. DOI: https://doi.org/10.1186/cc12904
Chavalarias D, Cointet JP. Phylomemetic patterns in science evolution—the rise and fall of scientific fields. PloS one. 2013;8(2):54847. DOI: https://doi.org/10.1371/journal.pone.0054847
Bentzer P, Fisher J, Kong HJ. Heparin-binding protein is important for vascular leak in sepsis. Int Care Med Experim. 2016;4:1-6. DOI: https://doi.org/10.1186/s40635-016-0104-3
Linder A, Åkesson P, Brink M, Studahl M, Björck L, Christensson B. Heparin-binding protein: a diagnostic marker of acute bacterial meningitis. Crit Care Med. 2011;39(4):812-7. DOI: https://doi.org/10.1097/CCM.0b013e318206c396
Katsoras K, Renieris G, Safarika A, Adami EM, Gkavigianni T, et al. Heparin-binding protein and procalcitonin predict sepsis in an emergency department setting: a prospective observational study. Critical Care. 2015;19(1):337.
Fisher J, Tverring J, Vaara ST, Poukkanen M, Pettila V, et al. Heparin-binding protein (HBP): A causative marker and a potential target for heparin treatment of human sepsis-induced acute kidney injury. Shock. 2017;48(3):313-20. DOI: https://doi.org/10.1097/SHK.0000000000000862