Evaluation of the biomarkers HMGB1 and IL-6 as predictors of mortality in cirrhotic patients with acute kidney injury

• Autor(a) principal: Célio Geraldo de Oliveira Gomes
• Data de Publicação: 2020
• Outros Autores: Marcus Vinicius Melo de Andrade, Ludmila Resende Guedes, Henrique Carvalho Rocha, Roberto Gardone Guimarães, Fernando Antônio Castro Carvalho, Eduardo Garcia Vilela
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1155/2020/2867241; http://hdl.handle.net/1843/51786; https://orcid.org/0000-0002-0506-9627; https://orcid.org/0000-0002-3716-0919; https://orcid.org/0000-0002-4103-7307; https://orcid.org/0000-0002-5443-7553
• topic: Acute kidney injury; Cirrhotic patients; Biomarkers; Morbidity; Mortality; Injúria renal aguda; Fibrose; Biomarcadores; Morbidade; Mortalidade

Background: Acute kidney injury (AKI) affects from 20% to 50% of cirrhotic patients, and the one-month mortality rate is 60%. The main cause of AKI is bacterial infection, which worsens circulatory dysfunction through the release of HMGB1 and IL-6. Objectives: To evaluate HMGB1 and IL-6 as biomarkers of morbidity/mortality. Methods: Prospective, observational study of 25 hospitalised cirrhotic patients with AKI. Clinical and laboratory data were collected at the time of diagnosis of AKI, including serum HMGB1 and IL-6. Results: The mean age was 55 years; 70% were male. Infections accounted for 13 cases. The 30-day and three-month mortality rates were 17.4% and 30.4%, respectively. HMGB1 levels were lower in survivors than in nonsurvivors at 30 days (1174.2 pg/mL versus 3338.5 pg/mL, p = 0:035), but not at three months (1540 pg/mL versus 2352 pg/mL, p = 0:243). Serum IL-6 levels were 43.3 pg/mL versus 153.3 pg/mL (p = 0:061) at 30 days and 35.8 pg/mL versus 87.9 pg/mL (p = 0:071) at three months, respectively. The area under the ROC curve for HMGB1 was 0.842 and 0.657, and that for IL-6 was 0.803 and 0.743 for discriminating nonsurvivors at 30 days and three months, respectively. In multivariate analysis, no biomarker was independently associated with mortality. Conclusion: HMGB1 levels were associated with decreased survival in cirrhotics. Larger studies are needed to confirm our results.