Abstract：
UNASSIGNED: Lactate is a commonly used biomarker for sepsis, although it has limitations in certain cases, suggesting the need for novel biomarkers. We evaluated the diagnostic accuracy of plasma renin concentration and renin activity for mortality and kidney outcomes in patients with sepsis with hypoperfusion or hypotension.
UNASSIGNED: This was a multicenter, prospective, observational study of 117 patients with septic shock treated at three tertiary emergency departments between September 2021 and October 2022. The accuracy of renin activity, renin, and lactate concentrations in predicting 28-day mortality, acute kidney injury (AKI), and renal replacement requirement was assessed using the area under the ROC curve (AUC) analysis.
UNASSIGNED: The AUCs of initial renin activity, renin, and lactate concentrations for predicting 28-day mortality were 0.66 (95% confidence interval [CI], 0.55-0.77), 0.63 (95% CI, 0.52-0.75), and 0.65 (95% CI, 0.53-0.77), respectively, and those at 24 hrs were 0.74 (95% CI, 0.62-0.86), 0.70 (95% CI, 0.56-0.83), and 0.67 (95% CI, 0.54-0.79). Renin concentrations and renin activity outperformed initial lactate concentrations in predicting AKI within 14 days. The AUCs of renin and lactate concentrations were 0.71 (95% CI, 0.61-0.80) and 0.57 (95% CI, 0.46-0.67), respectively (P=0.030). The AUC of renin activity (0.70; 95% CI, 0.60-0.80) was also higher than that of lactate concentration (P=0.044).
UNASSIGNED: Renin concentration and renin activity show comparable performance to lactate concentration in predicting 28-day mortality in patients with septic shock but superior performance in predicting AKI.
UNASSIGNED: This was a multicenter, prospective, observational study of 117 patients with septic shock treated at three tertiary emergency departments between September 2021 and October 2022. The accuracy of renin activity, renin, and lactate concentrations in predicting 28-day mortality, acute kidney injury (AKI), and renal replacement requirement was assessed using the area under the ROC curve (AUC) analysis.
UNASSIGNED: The AUCs of initial renin activity, renin, and lactate concentrations for predicting 28-day mortality were 0.66 (95% confidence interval [CI], 0.55-0.77), 0.63 (95% CI, 0.52-0.75), and 0.65 (95% CI, 0.53-0.77), respectively, and those at 24 hrs were 0.74 (95% CI, 0.62-0.86), 0.70 (95% CI, 0.56-0.83), and 0.67 (95% CI, 0.54-0.79). Renin concentrations and renin activity outperformed initial lactate concentrations in predicting AKI within 14 days. The AUCs of renin and lactate concentrations were 0.71 (95% CI, 0.61-0.80) and 0.57 (95% CI, 0.46-0.67), respectively (P=0.030). The AUC of renin activity (0.70; 95% CI, 0.60-0.80) was also higher than that of lactate concentration (P=0.044).
UNASSIGNED: Renin concentration and renin activity show comparable performance to lactate concentration in predicting 28-day mortality in patients with septic shock but superior performance in predicting AKI.
摘要：
■乳酸是脓毒症的常用生物标志物，尽管它在某些情况下有局限性，这表明需要新的生物标志物。我们评估了血浆肾素浓度和肾素活性对低灌注或低血压脓毒症患者死亡率和肾脏结局的诊断准确性。
■这是一个多中心，prospective,2021年9月至2022年10月,在三个三级急诊科接受治疗的117例感染性休克患者的观察性研究.肾素活性的准确性，肾素,和乳酸浓度预测28天死亡率，急性肾损伤(AKI),使用ROC曲线下面积（AUC）分析评估肾脏替代需求。
■初始肾素活性的AUC，肾素,预测28天死亡率的乳酸浓度为0.66(95%置信区间[CI]，0.55-0.77)，0.63（95%CI，0.52-0.75），和0.65（95%CI，0.53-0.77），分别,24小时为0.74（95%CI，0.62-0.86），0.70（95%CI，0.56-0.83），和0.67（95%CI，0.54-0.79）。在预测14天内的AKI时，肾素浓度和肾素活性优于初始乳酸浓度。肾素和乳酸浓度的AUC分别为0.71（95％CI，0.61-0.80）和0.57（95％CI，0.46-0.67），分别为(P=0.030)。肾素活性的AUC（0.70；95％CI，0.60-0.80）也高于乳酸浓度（P=0.044）。
■肾素浓度和肾素活性在预测感染性休克患者28天死亡率方面表现与乳酸浓度相当，但在预测AKI方面表现优异。
■这是一个多中心，prospective,2021年9月至2022年10月,在三个三级急诊科接受治疗的117例感染性休克患者的观察性研究.肾素活性的准确性，肾素,和乳酸浓度预测28天死亡率，急性肾损伤(AKI),使用ROC曲线下面积（AUC）分析评估肾脏替代需求。
■初始肾素活性的AUC，肾素,预测28天死亡率的乳酸浓度为0.66(95%置信区间[CI]，0.55-0.77)，0.63（95%CI，0.52-0.75），和0.65（95%CI，0.53-0.77），分别,24小时为0.74（95%CI，0.62-0.86），0.70（95%CI，0.56-0.83），和0.67（95%CI，0.54-0.79）。在预测14天内的AKI时，肾素浓度和肾素活性优于初始乳酸浓度。肾素和乳酸浓度的AUC分别为0.71（95％CI，0.61-0.80）和0.57（95％CI，0.46-0.67），分别为(P=0.030)。肾素活性的AUC（0.70；95％CI，0.60-0.80）也高于乳酸浓度（P=0.044）。
■肾素浓度和肾素活性在预测感染性休克患者28天死亡率方面表现与乳酸浓度相当，但在预测AKI方面表现优异。
