title: Diagnostic value of urine sCD163 levels for sepsis and relevant acute kidney injury: a prospective study.
abstract: BACKGROUND
  Sepsis is a common syndrome in critically ill patients and easily leads to the occurrence of acute kidney injury (AKI), with high mortality rates. This study aimed to investigate the diagnostic value of urine soluble CD163 (sCD163) for identification of sepsis, severity of sepsis, and for secondary AKI, and to assess the patients' prognosis.
  
  
  METHODS
  We enrolled 20 cases with systemic inflammatory response syndrome (SIRS), 40 cases with sepsis (further divided into 17 sepsis cases and 23 severe sepsis cases) admitted to the intensive care unit (ICU), and 20 control cases. Results for urine sCD163 were recorded on the day of admission to the ICU, and AKI occurrence was noted.
  
  
  RESULTS
  On the day of ICU admission, the sepsis group exhibited higher levels of urine sCD163 (74.8 ng/ml; range: 47.9-148.3 ng/ml) compared with those in the SIRS group (31.9 ng/ml; 16.8-48.0, P < 0.001). The area under the curve (AUC) was 0.83 (95% confidence interval [CI]: 0.72-0.94, P < 0.001) the sensitivity was 0.83, and the specificity was 0.75 (based on a cut-off point of 43.0 ng/ml). Moreover, the severe sepsis group appeared to have a higher level of sCD163 compared with that in the sepsis group (76.2; 47.2-167.5 ng/ml vs. 74.2; 46.2-131.6 ng/ml), but this was not significant. For 15 patients with AKI, urine sCD163 levels at AKI diagnosis were significantly higher than those of the remaining 35 sepsis patients upon ICU admission (121.0; 74.6-299.1 ng/ml vs. 61.8; 42.8-128.3 ng/ml, P = 0.049). The AUC for urine sCD163 was 0.688 (95% CI: 0.51-0.87, P = 0.049). Sepsis patients with a poor prognosis showed a higher urine sCD163 level at ICU admission (98.6; 50.3-275.6 ng/ml vs. 68.0; 44.8-114.5 ng/ml), but this was not significant. Patients with AKI with a poor prognosis had higher sCD163 levels than those in patients with a better prognosis (205.9; 38.6-766.0 ng/ml vs. 80.9; 74.9-141.0 ng/ml), but this was not significant.
  
  
  CONCLUSIONS
  This study shows, for the first time, the potential value of urine sCD163 levels for identifying sepsis and diagnosing AKI, as well as for assessment of patients' prognosis.
  
  
  BACKGROUND
  ChiCTR-ONC-10000812.
authors.affiliation: Department of Respiratory Medicine, Hainan Branch of the Chinese PLA General Hospital, Sanya, Hainan Province, 572013, China.
authors.forename: Longxiang
authors.initials: L
authors.lastname: Su
authors.forename: Lin
authors.initials: L
authors.lastname: Feng
authors.forename: Changting
authors.initials: C
authors.lastname: Liu
authors.forename: Zhaoxu
authors.initials: Z
authors.lastname: Jiang
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Kun
authors.initials: K
authors.lastname: Xiao
authors.forename: Peng
authors.initials: P
authors.lastname: Yan
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Jia
authors.forename: Dan
authors.initials: D
authors.lastname: Feng
authors.forename: Lixin
authors.initials: L
authors.lastname: Xie
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000652:urine*; D015214:Antigens, Differentiation, Myelomonocytic / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011956:Receptors, Cell Surface; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D000098902:CD163 Antigen
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D000098902:CD163 Antigen; D011956:Receptors, Cell Surface