Abstract
BackgroundGalectin-1 (Gal-1), a member of the β-galactoside binding protein family, is associated with inflammation and chronic kidney disease. However, the effect of Gal-1 on mortality and acute kidney injury (AKI) in critically-ill patients remain unclear.MethodsFrom May 2018 to March 2020, 350 patients admitted to the medical intensive care unit (ICU) of Taipei Veterans General Hospital, a tertiary medical center, were enrolled in this study. Forty-one patients receiving long-term renal replacement therapy were excluded. Serum Gal-1 levels were determined within 24 h of ICU admission. The patients were divided into tertiles according to their serum Gal-1 levels (low, serum Gal-1 < 39 ng/ml; median, 39–70 ng/ml; high, ≥71 ng/ml). All patients were followed for 90 days or until death.ResultsMortality in the ICU and at 90 days was greater among patients with elevated serum Gal-1 levels. In analyses adjusted for the body mass index, malignancy, sepsis, Sequential Organ Failure Assessment (SOFA) score, and serum lactate level, the serum Gal-1 level remained an independent predictor of 90-day mortality [median vs. low: adjusted hazard ratio (aHR) 2.11, 95% confidence interval (CI) 1.24–3.60, p = 0.006; high vs. low: aHR 3.21, 95% CI 1.90–5.42, p < 0.001]. Higher serum Gal-1 levels were also associated with a higher incidence of AKI within 48 h after ICU admission, independent of the SOFA score and renal function (median vs. low: aHR 2.77, 95% CI 1.21–6.34, p = 0.016; high vs. low: aHR 2.88, 95% CI 1.20–6.88, p = 0.017). The results were consistent among different subgroups with high and low Gal-1 levels.ConclusionSerum Gal-1 elevation at the time of ICU admission were associated with an increased risk of mortality at 90 days, and an increased incidence of AKI within 48 h after ICU admission.
Highlights
Galectin 1 (Gal-1) is a member of the galectin family that has one carbohydrate recognition domain
In analyses adjusted for the body mass index, malignancy, sepsis, Sequential Organ Failure Assessment (SOFA) score, and serum lactate level, the serum Gal-1 level remained an independent predictor of 90-day mortality [median vs. low: adjusted hazard ratio 2.11, 95% confidence interval (CI) 1.24–3.60, p = 0.006; high vs. low: aHR 3.21, 95% confidence intervals (CIs) 1.90–5.42, p < 0.001]
88.4% of patients in the intensive care unit (ICU) had at least two criteria of systemic inflammatory response syndrome (SIRS) [13]. In this single-center observational study, we examined associations of the serum Gal-1 level with all-cause mortality and acute kidney injury (AKI) in septic or critically ill patients admitted to the ICU
Summary
Galectin 1 (Gal-1) is a member of the galectin family that has one carbohydrate recognition domain. It is expressed throughout the body and involved in T-cell homeostasis, which in turn regulates the immune response and host–pathogen interaction [1]. Gal-1 is reported to be the mediator of cardiovascular inflammation [5] It mediates the interaction of cancer cells with the extracellular matrix [6]. Gal-1’s role in critically ill patients remains poorly understood. Galectin-1 (Gal-1), a member of the β-galactoside binding protein family, is associated with inflammation and chronic kidney disease. The effect of Gal-1 on mortality and acute kidney injury (AKI) in critically-ill patients remain unclear
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