Urinary orosomucoid: a novel, early biomarker of sepsis with promising diagnostic performance.
BACKGROUND
In order to help clinical decision making, we investigated the diagnostic and prognostic ability of urinary orosomucoid (u-ORM) as a new sepsis biomarker, and compared its performance to classical inflammatory parameters.


METHODS
We monitored u-ORM in septic (n=43) and SIRS (n=13) patients in a 5-day follow-up study vs. control patients (n=30). U-ORM was measured by a newly developed turbidimetric assay. U-ORM values were referred to urinary creatinine and expressed as u-ORM/u-CREAT (mg/mmol).


RESULTS
Significantly higher (p<0.001) u-ORM/u-CREAT levels were found in sepsis than in SIRS. Both intensive care unit (ICU) groups showed strongly elevated values compared to controls (p<0.001). The medians of admission u-ORM/u-CREAT levels were 19.2 in sepsis, 2.1 in SIRS and 0.2 mg/mmol in controls. The area under the receiver operating characteristic curve for distinguishing SIRS from sepsis was found to be 0.954 for u-ORM/u-CREAT, superior to serum ORM and hsCRP. U-ORM levels did not change during the 5-day follow-up and were independent of the severity of sepsis however, we found extremely elevated u-ORM/u-CREAT values in dialyzed septic patients (52.2 mg/mmol as median).


CONCLUSIONS
The early and relevant increase of u-ORM in sepsis suggests that it might be a promising novel marker of sepsis and could be a valuable part of routine laboratory and clinical practice.
Péter
P
Kustán
Balázs
B
Szirmay
Zoltán
Z
Horváth-Szalai
Andrea
A
Ludány
Gábor L
GL
Kovács
Attila
A
Miseta
Tamás
T
Kőszegi
Diána
D
Mühl
D000368:Aged; D015415:Biomarkers / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000652:urine*; D018805:Sepsis / Q000175:diagnosis* / Q000652:urine*
D015415:Biomarkers; D009961:Orosomucoid