Hang Yi,1 Ruiping Ye,2 Jinfeng Wang,3 Lin Gao,4 Weiwei Zhang,4 Chao Liu4 

1Department of Intensive Care Medicine, Qianjiang Central Hospital, Qianjiang City, Hubei Province, 433100, People’s Republic of China; 2Department of Intensive Care Medicine, The First People’s Hospital of Dingnan County, Ganzhou City, Jiangxi Province, 341900, People’s Republic of China; 3Department of Oncology, The First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, People’s Republic of China; 4Department of Intensive Care Medicine, Ganzhou People’s Hospital, Ganzhou City, Jiangxi Province, 341000, People’s Republic of China

Correspondence: Chao Liu, Department of Intensive Care Medicine, Ganzhou People’s Hospital, No. 16, Meiguan Avenue, Zhanggong District, Ganzhou City, Jiangxi Province, People’s Republic of China, Email a15116461784@126.com

Objective: To investigate the diagnostic value of serum fibrinogen domain-containing lectin-3 (Ficolin-3) and galectin-3 (Gal-3) in sepsis-associated acute kidney injury (SA-AKI).
Methods: This study retrospectively analyzed 126 SA-AKI patients with SA-AKI and 103 septic patients without AKI as controls. Based on the severity of renal injury, the SA-AKI patients were divided into three groups: mild (41 cases), moderate (53 cases), and severe (32 cases). Serum levels of Ficolin-3 and Gal-3 were measured using ELISA, and their correlation was determined through Pearson analysis. Multivariate logistic regression was used to identify factors associated with the occurrence of SA-AKI.
Results: The serum creatinine (SCr), blood urea nitrogen (BUN), as well as the expression levels of serum Ficolin-3 and Gal-3 in the SA-AKI group were higher than those in the non SA-AKI group (P< 0.05). The expression levels of Ficolin-3 and Gal-3 in the serum of the SA-AKI group were also higher than those of the non SA-AKI group (P< 0.05). The expression levels of Ficolin-3 and Gal-3 in serum gradually increased with the severity of renal injury in SA-AKI patients (P< 0.05). The expression levels of Ficolin-3 and Gal-3 in serum were greatly positively correlated (P< 0.001). Elevated levels of BUN, Ficolin-3, and Gal-3 were risk factors affecting the occurrence of SA-AKI (P< 0.05). The area under the curve (AUC) of serum Ficolin-3 and Gal-3 for individual diagnosis of SA-AKI was 0.877 and 0.867, respectively, the AUC of their combined diagnosis was 0.953, and the diagnostic sensitivity was higher than that of their individual diagnosis (P< 0.001).
Conclusion: The expression levels of serum Ficolin-3 and Gal-3 are closely related to associated with the onset and progression of SA-AKI and hold diagnostic value for its detection. Furthermore, the combined use of both markers provides a more accurate diagnosis than either marker alone.

Keywords: Sepsis complicated with acute kidney injury, Fibrinogen domain-containing lectin-3, Galectin-3