Effects of predictive value of miRNA-21 and miRNA-107-5p on 28-day mortality in patients with sepsis-induced acute kidney injury

Abstract

Objective To investigate the value of miR-21 and miR-107-5p in predicting 28-day mortality in patients with sepsis-induced acute kidney injury. Methods 75 patients with sepsis-induced acute kidney injury (AKI) and 41 patients with sepsis but without AKI (control) were examined for serum levels of miR-21 and miR-107-5p using qRT-PCR. The patients were followed up for 28 days to record their survival. Pearson correlation analysis was used to test the correlations of miR-21 and miR-107-5p with serum creatinine (Scr), cystatin C (Cys- C), BUN and KIM-1 in patients with AKI. Multivariate logistic regression analysis was used to analyze the correlations of miR-21, miR-107-5p, 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-21 combined with miR-107-5p was assessed for their value in predicting the prognosis of the patients. Results During the 28 day follow-up, 22 of the 75 (28.84%) AKI patients died. Compared with the survivors, the patients died within 28 days showed significantly increased serum levels of Scr (P=0.022)、BUN(P=0.035) and Cys-C(P=0.033)、miR-21 (P=0.025) and miR-107-5p (P=0.031). Pearson correlation analysis showed that miR-21 and miR-107-5p were positively correlated with serum Scr, Cys- C, and KIM-1 levels; multivariate regression analysis identified miR-21 and miR-107-5p as the independent risk factors for mortality in the septic patients. The ROC curve analysis showed that the areas under the curve (AUC) of miR-21 and miR-107-5p were (95%CI, 0.73~0.78, P=0.032) and 0.73(95%CI, 0.59~0.96, P=0.041), and that of Scr, BUN, Cys-C and KIM-1 were 0.68(95%CI, 0.56~0.76), 0.69(95%CI, 0.53~0.74), 0.81(95%CI, 0.63~0.84) and 0.79(95%CI, 0.72~0.81), respectively. The AUC of miR-21 combined with and miR-107-5p was significantly greater than that of miR-21, miR-107-5p, Scr, Cys-C and KIM-1 alone (P<0.05). Conclusion miR-21 and miR-107-5p have good predictive value in assessing the 28-day mortality of patients with sepsis. Key words: Sepsis; miR-21; miR-107-5p; Acute kidney; Mortality