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Association between Thymosin beta-4, acute kidney injury, and mortality in patients with sepsis: An observational cohort study.
- Source :
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International immunopharmacology [Int Immunopharmacol] 2021 Dec; Vol. 101 (Pt A), pp. 108167. Date of Electronic Publication: 2021 Oct 01. - Publication Year :
- 2021
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Abstract
- Background: Sepsis is a systemic inflammatory response syndrome, associated with high risk of acute kidney injury (AKI) and in-hospital mortality. Thymosin beta-4 (Tβ4) is an actin-sequestering protein that can prevent inflammation in several tissues. Thus, we studied the role of Tβ4 in sepsis.<br />Methods: The Tβ4 concentrations were prospectively measured in 191 patients within 6 h of the intensive care units (ICU) admission with diagnosis of sepsis. The cohort was divided into Tβ4 concentration tertiles: 1.19-7.11 ng/ml (n = 64), 7.12-11.01 ng/ml (n = 64), and 11.02-28.10 ng/ml (n = 63).<br />Results: Of 191 patients, 92 patients developed AKI, 24 of whom received continuous renal replacement therapy (CRRT), 29 patients died within 7 days, and 53 patients died within 28 days. Lower Tβ4 stages were correlated with poor prognosis, including AKI(odds ratio [OR], 2.102 per stage lower; 95% confidence interval [CI], 1.448 to 3.050; P < 0.001), CRRT(OR, 2.346 per stage lower; 95% CI, 1.287 to 4.276; P = 0.005), 7-day mortality(OR, 1.755 per stage lower; 95% CI, 1.050 to 2.935; P = 0.032), and 28-day mortality(OR, 1.821 per stage lower; 95% CI, 1.209 to 2.743; P = 0.004). Kaplan-Meier analysis also demonstrated that patients with lower Tβ4 stages had a high risk of AKI and death. In addition, the area under the curve (AUC) of Tβ4 for predicting AKI, CRRT, 7-day mortality, and 28-day mortality were, respectively, 0.702 (95% CI 0.628-0.776), 0.717 (95% CI 0.592-0.842), 0.694 (95% CI 0.579-0.808), and 0.682 (95% CI 0.598-0.767).<br />Conclusions: Lower Tβ4 stages are associated with higher odds of poor prognosis in ICU patients with sepsis.<br /> (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Acute Kidney Injury immunology
Acute Kidney Injury mortality
Acute Kidney Injury therapy
Aged
Biomarkers blood
Female
Hospital Mortality
Humans
Intensive Care Units statistics & numerical data
Kaplan-Meier Estimate
Male
Middle Aged
Prognosis
Prospective Studies
Renal Replacement Therapy statistics & numerical data
Risk Assessment methods
Risk Factors
Sepsis blood
Sepsis immunology
Sepsis mortality
Acute Kidney Injury epidemiology
Sepsis complications
Thymosin blood
Subjects
Details
- Language :
- English
- ISSN :
- 1878-1705
- Volume :
- 101
- Issue :
- Pt A
- Database :
- MEDLINE
- Journal :
- International immunopharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 34607232
- Full Text :
- https://doi.org/10.1016/j.intimp.2021.108167