Prediction of acute kidney injury using a combined model of inflammatory vascular endothelium biomarkers and ultrasound indices

Article type: Research Article

Authors: Abdelwahed, Omaima Mohammed^a | Aboulhoda, Basma Emad^b | Awadallah, Maryse Youssef^c | Gouda, Sarah Ali Abdelhameed^a | Abdallah, Hend^b | Rashed, Laila^d | Khaled, Mai^e | Ghobrial, Emad E.^f | Alghabban, Hadel M.^g | Sharawy, Nivin^{a; *}

Affiliations: [a] Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt | [b] Department of Anatomy, Faculty of Medicine, Cairo University, Cairo, Egypt | [c] Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt | [d] Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt | [e] Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt | [f] Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt | [g] Department of Biochemistry and Molecular Medicine, College of Medicine, Taibah University, Medina, Saudi Arabia

Correspondence: [*] Corresponding author: Nivin Sharawy, Kasr El-Aini, Cairo University, AlSaray Street, 11562 Cairo, Egypt. Tel.: +202 01122433182; Fax: +202 23628246; E-mail: [email protected], [email protected].

Abstract: BACKGROUND: Acute kidney injury (AKI) is a common complication of sepsis, with the burden of long hospital admission. Early prediction of AKI is the most effective strategy for intervention and improvement of the outcomes. OBJECTIVE: In our study, we aimed to investigate the predictive performance of the combined model using ultrasound indices (grayscale and Doppler indieces), endothelium injury (E-selectin, VCAM-1, ICAM1, Angiopoietin 2, syndecan-1, and eNOS) as well as inflammatory biomarkers (TNF-a, and IL-1β) to identify AKI. METHODS: Sixty albino rats were divided into control and lipopolysaccharide (LPS) groups. Renal ultrasound, biochemical and immunohistological variables were recorded 6 hrs, 24 hrs, and 48 hrs after AKI. RESULTS: Endothelium injury and inflammatory markers were found to be significantly increased early after AKI, and correlated significantly with kidney size reduction and renal resistance indices elevation. CONCLUSIONS: Using area under the curve (AUC), the combined model was analyzed based on ultrasound and biochemical variables and provided the highest predictive value for renal injury.

Keywords: Ultrasound, kidney, endothelium, inflammation, predictive, fibrosis

DOI: 10.3233/CH-231754

Journal: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 283-301, 2023