Evaluation of the Wnt signaling pathway as a prognostic marker in patients with urosepsis
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Evaluation of the Wnt signaling pathway as a prognostic marker in patients with urosepsis Jungho Shin1 · Yoosik Yoon2 · Dong‑Jin Oh3 Received: 28 March 2020 / Accepted: 18 June 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The Wnt signaling pathway has critical roles in dysregulated inflammation during sepsis; however, its impacts on clinical outcomes remain uncertain. This prospective observational study investigated the association between the Wnt pathway and clinical outcomes in patients with urosepsis. The study included 38 patients with urosepsis and 20 healthy individuals. Wnt3a and Wnt5a levels were measured at admission. The primary outcome was the occurrence of major adverse kidney events (MAKE), defined as new renal replacement therapy, stage 3 acute kidney injury, or death. Both Wnt3a and Wnt5a levels were higher in the patient group than in the control (P = 0.001 and P 38 or 90 bpm, white blood cell count 12 × 109/L, or respiratory rate > 20/min or PaCO2 18 years of age) with urinary tract infection admitted to the intensive care unit of the Myongji Hospital were screened for sepsis according to the 2012 Surviving
The baseline demographic, clinical, and laboratory data were collected at admission. The baseline disease severity was assessed using the Acute Physiology and Chronic Health Evaluation (APACHE) III and the Sequential Organ Failure Assessment (SOFA) score. To calculate severity scores, related parameters were obtained at the time of admission [21, 22]. Inpatient serum creatinine levels at day 0, day 5, and at discharge day were obtained for accessing renal recovery. Serum levels of Wnt3a and Wnt5a were measured at the time of inclusion in the study. Briefly, the serum was centrifuged at 1,000 × g for 20 min, aliquoted and stored at − 80 °C. Levels of Wnt3a and Wnt5a proteins were evaluated using the enzyme-linked immunosorbent assay
Fig. 1 Study flow chart of subject inclusion. Among individuals who visited the hospital for health screening, they were requested for the study inclusion. On the other hand, adult patients with urosepsis who
admitted to the intensive care unit from January 2018 to July 2019 were eligible for the patient group. Several numbers of eligible subjects were excluded due to refusal, sample error and withdrawal
Materials and methods Study design and subjects
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Molecular and Cellular Biochemistry
(ABclonal Biotechnology, Woburn, MA, USA). The assays were performed according to the manufacturer’s instructions.
Table 1 Baseline characteristics in the control and urosepsis groups
Outcomes
Age, years 59 (58, 63) Male, n (%) 10 (50.0) Comorbidities, n (%) Hypertension Diabetes Chronic kidney disease Heart failure Coronary artery disease Chronic liver disease Malignancy APACHE III SOFA Septic shock, n (%)
The primary composite outcome was the incidence of Major Adverse Kidney Events (MAKE), which was defined as new renal replacement therapy, stage 3 AKI, or death. AKI was defined following the guideline of the Ki
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