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Plasma Linoleic Acid Is Associated With Pediatric Sepsis Phenotype and Acute Kidney Injury

Ivan E Saraiva1, Dana Y Fuhrman2, Kate F Kernan2

  • 1Program for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|March 20, 2026
PubMed

Insights

Higher levels of linoleic acid (LA) and its oxylipins are linked to a severe sepsis phenotype (D) and acute kidney injury (AKI) in critically ill children. This suggests a role for lipid metabolism in sepsis-related organ dysfunction.

Area of Science:

  • Biochemistry
  • Pediatric Critical Care Medicine
  • Metabolomics

Background:

  • Linoleic acid (LA) is a dietary polyunsaturated fatty acid and a precursor to inflammatory oxylipins.
  • The specific role of LA and its oxylipins in pediatric sepsis and organ injury remains unclear.
  • Pediatric sepsis phenotype D is associated with high rates of acute kidney injury (AKI), multiple organ failure, and mortality.

Purpose of the Study:

  • To investigate the association between plasma LA and LA-derived oxylipins with sepsis phenotype D in critically ill children.
  • To determine if LA and its oxylipins are associated with AKI in this patient cohort.

Main Methods:

  • A subset of 108 pediatric sepsis patients from the PHENOMS cohort was analyzed using untargeted metabolomics.
  • Plasma samples were used to measure LA and LA-derived oxylipins.
  • Outcomes included sepsis phenotype, AKI (creatinine > 1 mg/dL and oliguria < 0.5 mL/kg/hr), other organ dysfunctions, and hospital mortality.

Main Results:

  • Elevated LA levels were significantly associated with sepsis phenotype D (OR, 1.67; P = 0.03).
  • LA-derived oxylipins (9-HODE/13-HODE) were also associated with sepsis phenotype D (OR, 1.26; P = 0.04).
  • While LA showed a trend, 9-HODE/13-HODE was significantly associated with AKI (OR, 1.27; P = 0.02).

Conclusions:

  • Plasma LA levels and LA-derived oxylipins are associated with pediatric sepsis phenotype D and AKI.
  • These findings highlight the potential role of lipid metabolism in sepsis-induced organ dysfunction.
  • Further mechanistic studies are warranted to explore these associations in sepsis pathophysiology.
Abstract

Keywords:
acute kidney injurylinoleic acidorgan dysfunctionoxylipinpolyunsaturated fatty acidsepsis phenotype

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