Predictive value of miRNA-29a and miRNA-10a-5p for 28-day mortality in patients with sepsis-induced acute kidney injury

HUO Rui; DAI Min; FAN Yi; ZHOU Jingzheng; LI Li; ZU Jian

doi:10.3969/j.issn.1673-4254.2017.05.13

Abstract：Objective To investigate the value of miR-29a and miR-10a-5p in predicting 28-day mortality in patients with sepsis-induced acute kidney injury.Methods Seventy-four patients with sepsis-induced acute kidney injury (AKI) and 41 patients with sepsis but without AKI (control) were examined for serum levels of miR-29a and miR-10a-5p using RT-PCR.The patients were followed up for 28 days to record their survival.Pearson correlation analysis was used to test the correlations of miR-29a and miR-10a-5p with serum creatinine (Scr),cystatin C (Cys-C),and KIM-1 in patients with AKI.Multivariate logistic regression analysis was used to analyze the correlations of miR-29a,miR-10a-5p,Scr,Cys-C,KIM-1 and other risk factors with the 28-day mortality in patients with sepsis.The predictive value of these indicators for evaluating the prognosis of patients with sepsis was analyzed using ROC curve,and miR-29a combined with miR-10a-5p was assessed for their value in predicting the prognosis of the patients.Result During the follow-up for 28 days,21 of the 74 (35.53％) AKI patients died.Compared with the survivors,the patients died within 28 days showed significantly increased serum levels of Scr,Cys-C,KIM-1,miR-29a,and miR-10a-5p (P＜0.05).Pearson correlation analysis showed that miR-29a and miR-10a-5p were positively correlated with serum Scr,Cys-C,and KIM-1 levels;multivariate regression analysis identified miR-29a and miR-10a-5p as the independent risk factors for mortality in the septic patients.The ROC curve analysis showed that the area under the curve (AUC) of miR-29a and miR-10a-5p was 0.82 (95％CI:0.71-0.89) and 0.75 (95％CI:0.64-0.85),and that of Scr,Cys-C and KIM-1 was 0.72 (95％CI:0.66-0.86),0.71 (95％ CI:0.63-0.84) and 0.81 (95％ CI:0.72-0.81),respectively.The AUC of miR-29a combined with miR-10a-5p was significantly greater than that of miR-29a,miR-10a-5p,Scr,Cys-C and KIM-1 alone (P＜0.05).Conclusion miR-29a and miR-10a-5p have good predictive value in assessing the 28-day mortality of patients with sepsis.