Proenkephalin is an Early Biomarker to Predict Septic Acute Kidney Injury among Patients in Intensive Care Unit

Author(s): Hassan MM, Arnob AS, Ahmed AHH, Rahman AKMS, Akbar AAG, Jabin P, Khan SB, Singha AK, Tahora S, Karim ANME

Background: Sepsis is the leading cause of acute kidney injury (AKI) in critically ill patients. Plasma Proenkephalin found to be highly specific for early kidney dysfunction and is not influenced by non renal related variables.

Objective: The aim of this study was to evaluate the plasma proenkephalin as a predictor of septic AKI in patients with sepsis or septic shock.

Methods: This prospective observational study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from January 2019 to December 2019. A total of 88 patients admitted in Intensive Care Unit (ICU), with sepsis or septic shock were enrolled. Their relevant data regarding different physiological parameters, markers of sepsis and vital organ functions were assessed daily. The patients’ serum creatinine and plasma Proenkephalin levels were measured on day 0, day 2 and on day 7 of admission in ICU. Their serum creatinine and plasma Proenkephalin levels were subsequently followed up on day 2 and day 7 to identify the development of AKI.

Results: The mean age of the study patients was 56.3±10.55 year. Among total 88 study patients; AKI was developed in 28 (31.8%) patients. It was observed that plasma Proenkephalin levels on day 0, day 2 and day 7 of admission were significantly increased among patients who developed AKI (p< 0.001).

Conclusion: The patients with AKI had a significant higher plasma Proenkephalin level than the patients without AKI. Therefore plasma Proenkephalin is a good early biomarker for the diagnosis of septic AKI.