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Urinary PKM2, a marker predicating acute kidney injury in patients with sepsis
Wu Jiajun1, Guo Kaifeng2, Zhou Jing3
1Department of Emergency, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Purpose:
Acute kidney injury (AKI) is a complication commonly occurred in patients with sepsis, and AKI has become the leading cause associated with mortality. PKM2, as a rate-limiting enzyme of glycolysis, was considered to be involved in AKI in vitro and animal models. However, there have been no studies reported on the expression of PKM2 in humans and its association with AKI.
Methods:
A retrospective study including 57 patients (35 males and 22 females) that were admitted into hospital in 2019 was carried out in our research. The basic characteristics and clinical parameters of each patient were collected from patients' medical records. We assessed changes in the expression of serum and urinary PKM2 using ELISA and its association with clinical manifestations in patients with sepsis through correlation analysis. Besides, ROC analysis was applied for evaluating the role of PKM2 in predicting AKI and death rate.
Results:
Urinary PKM2 is obviously increased in patients with sepsis-associated AKI (P < 0.05), while no significant change was found in the expression of serum PKM2. Moreover, the expression of urinary PKM2 is positively correlated with serum creatinine (r=0.577, P < 0.01) and blood-urea-nitrogen (r=0.531, P<0.01). In addition, it is negatively correlated with glomerular filtration rate (r=-0.583, P<0.01). Besides, ROC analysis indicated that urinary PKM2 could be a predictor of AKI in patients with sepsis (AUC-ROC, 0.819; SE, 0.086, P = 0.004, 95% CI 0.651-0.986).
Conclusions:
Urinary PKM2 could be a marker predicting acute kidney injury in patients with sepsis.
Insights
Urinary pyruvate kinase M2 (PKM2) levels are elevated in patients with sepsis-associated acute kidney injury (AKI). This finding suggests urinary PKM2 may serve as a valuable biomarker for predicting AKI in sepsis patients.
Area of Science:
- Biochemistry
- Nephrology
- Critical Care Medicine
Background:
- Sepsis-induced acute kidney injury (AKI) is a major cause of mortality.
- Pyruvate kinase M2 (PKM2), a key glycolytic enzyme, has been implicated in AKI in preclinical models.
- Human studies on PKM2 expression and its role in sepsis-associated AKI are lacking.
Purpose of the Study:
- To investigate the expression of PKM2 in humans with sepsis.
- To determine the association between PKM2 expression and AKI in sepsis patients.
- To evaluate PKM2 as a potential biomarker for AKI and mortality in sepsis.
Main Methods:
- Retrospective study of 57 sepsis patients.
- Measurement of serum and urinary PKM2 levels using ELISA.
- Correlation analysis of PKM2 expression with clinical parameters (creatinine, BUN, GFR).
- Receiver Operating Characteristic (ROC) analysis to assess predictive value for AKI and mortality.
Main Results:
- Urinary PKM2 levels were significantly increased in sepsis patients with AKI.
- Serum PKM2 levels showed no significant change.
- Urinary PKM2 correlated positively with creatinine and BUN, and negatively with GFR.
- ROC analysis indicated urinary PKM2 as a potential predictor of AKI in sepsis (AUC=0.819).
Conclusions:
- Urinary PKM2 is elevated in sepsis-associated AKI.
- Urinary PKM2 shows potential as a non-invasive biomarker for predicting AKI in sepsis patients.
