Evaluating Continuous Veno-venous Hemodiafiltration Treatment Effects on Biomarkers and Outcomes in Sepsis-Induced Acute Kidney Injury

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INTRODUCTION: Acute kidney injury (AKI) is commonly precipitated by sepsis. Continuous veno-venous hemofiltration (CVVHD) is a critical intervention for managing AKI, but further exploration is needed to understand its effects on novel renal injury markers and patient outcomes. The aim of this study is to evaluate the impact of CVVHD on novel renal injury markers and its prognostic significance in individuals suffering from sepsis-related AKI. METHODS: Retrospective analysis was carried out on the medical data of 84 patients with sepsis-induced AKI treated at Baoji High-Tech Hospital from February 2022 to August 2023. We assessed changes in serum biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and liver fatty acid-binding protein (L-FABP) pre- and post-CVVHDF treatment, and correlated these changes with the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Cox regression was utilized to identify independent prognostic factors influencing 28-day survival, from which Kaplan-Meier curves and a prognostic nomogram were derived. RESULTS: A significant reduction in the serum concentrations of s-NGAL, L-FABP, and KIM-1 was observed following treatment (all P < .001). A positive correlation between these serum biomarkers and APACHE II scores was observed both before and after CVVHDF treatment (all P < .001). According to multivariate Cox regression analysis, coronary heart disease (P = .016), the stage of renal injury (P = .014), APACHE II score (P < .001), and s-NGAL (P < .001) were independent predictors of prognosis for 28-day survival. CONCLUSION: CVVHD effectively decreases KIM-1, L-FABP, and NGAL levels, thereby enhancing kidney function in individuals suffering from sepsis-related AKI. Key prognostic indicators for 28-day survival include the presence of coronary artery disease, advanced kidney injury stage, APACHE II score ≥ 26, and NGAL levels ≥ 5.49.

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