The Evaluation Of The Relationship Between Angiotensin And Acute Kidney Injury In Patients With Sepsis

Objective: The changes of plasma angiotensin(Ang)in patients with sepsis were analyzed to evaluate the relationship between Ang and acute kidney injury(AKI)and explore its value in early warning of sepsis AKI,assessment of severity of the disease and prediction of prognosis.Methods: In this prospective study,66 sepsis patients admitted to intensive care unit(ICU)of our hospital from October 2020 to January 2021 were involved and divided into AKI group and non-AKI group according to the occurrence of AKI.Patients in AKI group were divided into improvement group and deterioration group according to the trend of renal function.The related clinical data,biochemical indexes(liver and kidney function,electrolyte),inflammation index(white blood cells,c-reactive protein),as well as the SOFA score and APACHE-Ⅱ score were recorded.Plasma was separated from sepsis patients and healthy controls,and plasma Ang concentration was determined by chemiluminescence method.Patients were followed up for prognosis.Results: 1.The plasma Ang-Ⅰ was higher in sepsis AKI patients than in sepsis non-AKI patients(P=0.039),and plasma Ang-Ⅱ / Ang-Ⅰ was lower in sepsis AKI patients(P=0.001).2.In the sepsis AKI patients,the plasma Ang-Ⅰbaseline levels was higher in deteriorating renal function group than in improving renal function group(P=0.04),and plasma Ang-Ⅱ/Ang-Ⅰ was lower in the deteriorating renal function group(P=0.02).3.Among the indicators such as hypertension,age,sex,albumin,SOFA score,APACHE-Ⅱscore and Ang,only SOFA score was an independent risk factor for AKI(P=0.002,OR=1.541).4.In correlation analysis,Ang-Ⅰ was negatively correlated with glomerular filtration rate(GFR),positively related to the SOFA score and no significant correlation with AKI classification.Ang-Ⅱ/Ang-Ⅰ was positively correlated with GFR.Conclusions: In sepsis patients,those with elevated Ang-Ⅰ or reduced Ang-Ⅱ/Ang-Ⅰ have a higher incidence of AKI.And the higher of the plasma Ang-Ⅰ,the worse of the prognosis of renal function.These results indicate that plasma Ang has reference value for early warning of AKI in sepsis patients and evaluating of severity of the disease and renal function prognosis.This can provide the basis for early intervention of renal function in sepsis patients,which may improve the prognosis of patients.Therefore,it has certain clinical significance.