Hepcidin, in contrast to heparin binding protein, does not portend acute kidney injury in patients with community acquired septic shock
Jon Olinder, Matilda Jovanovic Stjernqvist, Albin Lindén, Evelina Thaphikul Salomonsson, Martin Annborn, Heiko Herwald, Cecilia Rydén
Abstract
Acute kidney injury (AKI) is a common and severe complication in patients treated at an Intensive Care Unit (ICU). The pathogenesis of AKI has been reported to involve hypoperfusion, diminished oxygenation, systemic inflammation, and damage by increased intracellular iron concentration.
Introduction
Sepsis and septic shock are consequences of a dysregulated host response to infection often complicated by acute kidney injury (AKI) [1–3]. AKI is a frequent organ dysfunction acquired by many patients in need of intensive care [2,3]. Sepsis-associated acute kidney injury (S-AKI) has reported mortality rates of up to 46–65% [2,3]. Furthermore, among survivors of S-AKI the risk of progression to chronic kidney disease (CKD) is substantial [4].
Materials and methods
This prospective observational study was conducted at the ICU in Helsingborg, Sweden from 1st of May 2014 until 31st of August 2020. No patients suffering from Sars-Cov-2 were included. The methods used in the study were performed according to relevant regulations and guidelines.
Result
A total of 178 patients were included in the study, 24 were excluded due to a CKD diagnosis, and 14 due to missing hepcidin or HBP values on the day of admission (Fig 1). Of the remaining 140 patients, 85 were diagnosed with sepsis (83 fulfilled the updated Sepsis-3 criteria of septic shock
Discussion
The clinical data presented in this study challenge the idea that serum hepcidin levels upon admission in intensive care patients serve as a marker for the development of acute kidney injury (AKI) [13]. Contrary to earlier reports, our findings do not align with the notion that elevated serum iron levels are linked to higher mortality in ICU patients with compromised kidney function [9].
Conclusion
Hepcidin and HBP serum concentrations at admission to the ICU were significantly higher in sepsis patients compared to critically ill patients with non-infectious conditions treated in the ICU
Citation: Olinder J, Stjernqvist MJ, Lindén A, Salomonsson ET, Annborn M, Herwald H, et al. (2024) Hepcidin, in contrast to heparin binding protein, does not portend acute kidney injury in patients with community acquired septic shock. PLoS ONE 19(5): e0299257. https://doi.org/10.1371/journal.pone.0299257
Editor: Timotius Ivan Hariyanto, Pelita Harapan University Faculty of Medicine: Universitas Pelita Harapan Fakultas Kedokteran, INDONESIA
Received: September 24, 2023; Accepted: February 7, 2024; Published: May 2, 2024
Copyright: © 2024 Olinder et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting information files.
Funding: J.O and C.R received funding from Stig and Ragna Gorthons fund for scientific research at Helsingborg hospital and Thelma Zoégas fund for medical research, Lund University. Funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Hansa Medical (Lund, Sweden) has filed patent applications on HBP as a diagnostic marker. Heiko Herwald is listed as inventor. All other authors have no conflicts of interest to declare.
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0299257#sec020
