ArticleInternational urology and nephrology2022
Impact of indirect bilirubin and uric acid on outcomes of sepsis-associated acute kidney injury (sAKI).
Article in International urology and nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Uric Acid to Albumin Ratio: A Predictive Marker for Acute Kidney Injury in Isolated Tricuspid Valve Surgery.Reviews in cardiovascular medicine · 2025Article
- Prognostic value of blood urea nitrogen to albumin ratio in septic patients with acute kidney injury-a retrospective study based on MIMIC database.Frontiers in medicine · 2025Article
- Lactate dehydrogenase is an indicator for outcomes of short-term and long-term in septic patients.PloS one · 2025Article
- Development and validation of a nutrition-integrated nomogram for predicting 28-day mortality in sepsis patients.Frontiers in nutrition · 2025Article
- Total bilirubin level is associated with acute kidney injury in neonates admitted to the neonatal intensive care units: based on MIMIC-III database.European journal of pediatrics · 2024Article
- The association of oxidative stress of neonatal hyperbilirubinemia and vitamin E supplementation.Clinical and experimental hepatology · 2024Article
- Association of Different Total Bilirubin Levels with Prognosis of Peritoneal Dialysis-Associated Peritonitis.Medicina (Kaunas, Lithuania) · 2023Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury (AKI) is one of the most frequent pathophysiologic disorders encountered in hospitalized patients, with sepsis frequently implicated in pathogenesis. Reactive oxygen species (ROS) seem to have a significant contribution to sepsis-induced AKI. Proposed mechanisms include induction of cell membrane lipid peroxidation, protein denaturing, and direct DNA damage, all of which have deleterious effect. These changes constitute oxidative injury to the kidneys.
objectiveTo evaluate the antioxidant actions of indirect bilirubin and uric acid on outcomes of sepsis-associated AKI.
methodsNinety-eight patients admitted to the intensive care unit (ICU), at a large tertiary center, with sepsis and AKI were evaluated for serum levels of uric acid, bilirubin (primarily indirect), and procalcitonin. The primary endpoints studied were the need for hemodialysis and death.
resultsThirty-two (33%) patients developed AKI requiring hemodialysis (HD). These patients had higher SOFA scores (p < 0.001) and lower levels of indirect bilirubin (p < 0.001) compared to those not requiring HD. There was no statistically significant difference in serum uric acid levels. Logistic regression analysis identified creatinine level, total and indirect bilirubin levels, and leukocyte count as significant predictors of patient death.
conclusionHigher leukocyte counts and creatinine levels were independently associated with poor outcomes in ICU patients with sepsis. Additionally, lower indirect bilirubin levels were also noted to be associated with similar outcomes. The latter provides insights into oxidative stress as a major player in the pathogenesis of sepsis-induced AKI, with a potential protective role of indirect bilirubin.
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