Protective effect of ulinastatin on renal function of patients with sepsis-induced acute kidney injury

Abstract

Objective To evaluate the protective mechanism and efficacy of ulinastatin(UTI) on leveld of urine neutrophil gelatinase associated lipocalin(NGAL), urine kidney injury molecule-1(Kim-1), plasma vystatin C(Cys C), plasma interleukin-18(IL-18)and kidney organ function in patients with sepsis-induced acute kidney injury. Methods Sixty-two patients with sepsisinduced acute kidney injury were divided into control group(group C,n= 31) and UTI treatment group (group UTI,n= 31) according to the random double blind method.The routine group was given routine treatment, including early recovery, monitoring lactate guiding rehydration, antibiotics application, mechanical ventilation, blood purification.On the basis of conventional treatment, the UTI group was given 300 000 U UTI dissolved in in 50 ml 0.9% normal saline,i.v., twice daily for 7 days.Urine NGAL, urine Kim-1, plasma Cys C,and plasma IL-18 were determined before and at 8th day after the treatment. Results After treatment, NGAL[(3.43±0.35)μg/L], Kim-1[(5.37±0.30)μg/L], Cys C[(9.29± 0.28)mg/L]and IL-18[(136.87±6.43)ng/L]in group C were significantly different from those before treatment[NGAL(0.92±0.10)μg/L, Kim-1(4.13±0.22)μg/L, Cys C(3.53±0.25) mg/L and IL-18(83.37±7.65) ng/L](P< 0.01). The UTI group had more significant difference[after treatment, NGAL(2.71±0.22)μg/L, Kim-1(4.79±0.23)μg/L, Cys C(7.29±0.33) mg/L and IL-18(110.28±6.86) ng/L vs.before treatment, NGAL(0.99±0.37)μg/L, Kim-1(4.21 ±0.25)μg/L, Cys C(3.50±0.25) mg/L and IL-18(84.27±7.51) ng/L,P< 0.01]. Conclusion Combined use of UTI can significantly reduce the NGAL, Kim-1, Cys C and IL-18 levels.UTI has beneficial effects on the protection of kidney in patients with sepsis-induced acute kidney injury. Key words: Ulinastatin; Sepsis; Acute kidney injury