| Abstract Objective: To investigate the correlation between serum levels of thioredoxin-1 (Trx-1), thioredoxin-interacting protein (TXNIP), NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and sepsis-associated acute kidney injury (SA-AKI) and their predictive value for mortality risk. Methods A total of 158 patients with SA-AKI were selected as the SA-AKI group. Another 158 sepsis patients without kidney injury were matched at a 1:1 ratio as the non-SA-AKI group. Serum levels of Trx-1, TXNIP, and NLRP3 were compared between the two groups. Pearson correlation analysis was used to assess the correlation between serum Trx-1, TXNIP, NLRP3 levels and renal function parameters. Serum levels of Trx-1, TXNIP, and NLRP3 were compared among patients with different stages of AKI. The predictive value of serum Trx-1, TXNIP, and NLRP3 levels for SA-AKI was analyzed using receiver operating characteristic (ROC) curves. SA-AKI patients were divided into a death group and a survival group based on 28-day survival status. Serum levels of Trx-1, TXNIP, and NLRP3 were compared between the two groups, and their predictive value for 28-day mortality in SA-AKI patients was assessed using ROC curves. Results: Compared with the non-SA-AKI group, serum levels of Trx-1, TXNIP, and NLRP3 were significantly higher in the SA-AKI group (Mean P< 0.05), and these levels increased progressively with higher AKI stages (Mean P< 0.05). Pearson correlation analysis showed positive pairwise correlations among serum Trx-1, TXNIP, and NLRP3 (Mean P< 0.05). Serum Trx-1, TXNIP, and NLRP3 levels were positively correlated with serum creatinine (Scr) and negatively correlated with estimated glomerular filtration rate (eGFR) (Mean P< 0.05). ROC curve analysis revealed that the combined measurement of serum Trx-1, TXNIP, and NLRP3 for predicting SA-AKI yielded a sensitivity of 85.41%, specificity of 74.13%, and area under the curve (AUC) of 0.875 (95%CI: 0.838-0.912). Among the 158 SA-AKI patients, 45 died within 28 days, with a mortality rate of 28.48%. Serum levels of Trx-1, TXNIP, and NLRP3 were significantly higher in the death group than in the survival group (Mean P< 0.05). The AUCs for predicting 28-day mortality in SA-AKI patients were 0.761 (95%CI: 0.678-0.844) for Trx-1, 0.730 (95%CI: 0.638-0.822) for TXNIP, 0.742 (95%CI: 0.659-0.825) for NLRP3, and 0.906 (95%CI: 0.853-0.958) for the three combined. Conclusion: Elevated serum levels of Trx-1, TXNIP, and NLRP3 are significantly associated with SA-AKI, disease severity, and 28-day mortality risk. The combined measurement of these three biomarkers has good predictive efficacy for poor prognosis in SA-AKI. |
