title: The value of serial serum cell adhesion molecules in predicting acute kidney injury after severe sepsis in adults.
abstract: BACKGROUND
  Septic acute kidney injury (AKI) is a common complication of severe sepsis. We tested the hypothesis that serum cell adhesion molecule levels are substantially increased in early septic AKI and decreased after antimicrobial therapy and their level can predict prognosis.
  
  
  METHODS
  Seventy-two nontraumatic, nonsurgical adult patients with severe sepsis admitted to the emergency department were evaluated. Serum adhesion molecules were collected and assessed. We evaluated their relationship with early septic AKI compared with other clinical predictors and biomarkers.
  
  
  RESULTS
  Forty-five patients (62.5%) experienced early septic AKI. Patients with septic AKI also were more likely to experience septic shock and respiratory failure and had higher in-hospital mortality. Stepwise logistic regression model revealed that E-selectin level, septic shock, and respiratory failure were independently associated with septic AKI and each 1ng/ml increase in serum E-selectin level increased the risk of septic AKI by 1%. Furthermore, the E-selectin levels in the septic AKI group were significantly higher than those in the non-AKI group at two different times (days 1 and 4).
  
  
  CONCLUSIONS
  WE show that early septic AKI implies a higher mortality in severe sepsis patients and that E-selectin level at presentation is a powerful predictor of early septic AKI.
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Chih-Min
authors.initials: CM
authors.lastname: Su
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Hsien-Hung
authors.initials: HH
authors.lastname: Cheng
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Hung
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Hsiao
authors.affiliation: Department of Emergency Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Tsai
authors.affiliation: Department of Emergency Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.affiliation: Department of Emergency Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Hung-Chen
authors.initials: HC
authors.lastname: Wang
authors.affiliation: Department of Emergency Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Lin
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Emergency Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Ben-Chung
authors.initials: BC
authors.lastname: Cheng
authors.affiliation: Department of Emergency Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Yu-Jih
authors.initials: YJ
authors.lastname: Su
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Emergency Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Chia-Te
authors.initials: CT
authors.lastname: Kung
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Emergency Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC; Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen, Fujian, PR China. Electronic address: chlu99@ms44.url.com.tw.
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications*; D000368:Aged; D015815:Cell Adhesion Molecules / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications*
chemical_list: D015815:Cell Adhesion Molecules
keywords: Cell adhesion molecule; Septic acute kidney injury; Severe sepsis