Clinical impact of Wnt5a expression on persistence of acute kidney injury in patients with urosepsis

Abstract

Abnormal Wnt5a expression is associated with dysregulated inflammation and organ dysfunction. However, the effect of Wnt5a activation on the duration of organ dysfunction remains unclear. This prospective study investigated the association between Wnt5a levels and persistent acute kidney injury (AKI) in patients with urosepsis. Serum creatinine and Wnt5a levels were measured on days 1 and 5 and at discharge in 87 patients diagnosed with urosepsis. Patients with urosepsis were classified into an improving acute kidney injury (AKI) group and a persistent or worsening AKI group according to the AKI stage on days 1 and 5. AKI recovery was defined as a discharge-to-baseline serum creatinine ratio of <1.5. Twenty-eight patients with urosepsis (32.2%) had persistent or worsening AKI, and their Wnt5a levels were higher on days 1 and 5 and at discharge than those with improving AKI. The association between Wnt5a levels and persistent or worsening AKI was maintained after adjusting for age, sex, baseline serum creatinine levels, and disease severity. Moreover, elevated Wnt5a levels were associated with an increased risk of major adverse kidney events. High Wnt5a levels at discharge were associated with unrecovered AKI and participants with AKI recovery had a steeper Wnt5a slope over time than those without recovery, irrespective of age, sex, baseline serum creatinine level, or disease severity. Assessment of Wnt5a expression was helpful in predicting AKI persistence and adverse outcomes in patients with urosepsis. Therefore, Wnt5a may serve as a valuable bio-marker for identifying the risk of persistence of AKI.

Keywords:

• Acute kidney injury
• major adverse kidney event
• renal recovery
• sepsis
• Wnt5a

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Myongji Hospital (No. MJH 2020-09-002).

Authors’ contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Jungho Shin, Yoosik Yoon, and Dong-Jin Oh. The first draft of the manuscript was written by Jungho Shin and Dong-Jin Oh. All authors read and approved the final manuscript.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

The datasets generated during and/or analyzed in the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by Samjin Pharmaceutical Co., Ltd, to which the authors extend their gratitude.