Abstract:

Objective To investigate the correlation between serum NOD⁃like receptor protein 3（NLRP3）and interleukin ⁃18（IL ⁃18）and the severity of septic acute kidney injury（AKI）. Methods In this prospectivestudy，56 patients with sepsis who were hospitalized in the ICU of the General Hospital of Ningxia Medical Universityfrom October 2018 to August 2020 were selected and divided into the sepsis group（26 cases）and sepsis AKI group（20 cases of mild AKI and10 of severe AKI）according to the Kidney Disease Improving Global Outcomes（KDIGO）diagnostic criteria，and 30 healthy subjects in the same period were selected as control group. The general data ofeach group were collected and compared. According to the 28⁃day mortality rate，the patients were divided intosurvival group（n = 30）and death group（n = 26）. The level of serum NLRP3 and IL⁃18 was detected and com⁃pared，and the correlation between serum NLRP3，IL⁃18 and urine NGAL and Kim⁃1 was analyzed. Risk factorsaffecting the prognosis of patients with sepsis AKI were analyzed，and receiver operating characteristic curve（ROC）was drawn to evaluate the predictive value of independent risk factors alone and in combination. Results Compared with that in the control group，the level of NLRP3 and IL⁃18 in sepsis group and sepsis AKI group washigher than that in sepsis mild AKI group，and the level of NLRP3 and IL⁃18 in sepsis severe AKI group was higherthan that in sepsis mild AKI group（P < 0.05）. Compared with that in the death group，the level of NLRP3 andIL ⁃18 in the survival group was lower，and the level of NLRP3 and IL ⁃18 was positively correlated with urinaryNGAL and Kim⁃1. Multivariate logistic regression analysis showed that serum NLRP3 was an independent factoraffecting the death of sepsis AKI（P < 0.05）. ROC curve analysis showed that the area under the ROC curve（AUC） of NLRP3 and APACHEⅡ score for predicting 28⁃day mortality of sepsis was 0.72 and 0.73，and the sensitivitywas 80% and 85% respectively. AUC of the combined detection of the above two indexes was 0.78，and the sensi⁃tivity was 95%，which was better than that of the single indicator（P < 0.05）. Conclusion The level of serumNLRP3 and IL⁃18 is closely related to the severity of AKI patients with sepsis.

Key words:

sepsis, acute kidney injury, NLRP3, IL?18