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ORIGINAL RESEARCH article

Front. Nephrol.
Sec. Critical Care Nephrology
Volume 4 - 2024 | doi: 10.3389/fneph.2024.1398386
This article is part of the Research Topic Novel Diagnostic and Prognostic Methods in Acute Kidney Injury Among Patients in Intensive Care Unit View all 5 articles

Prognostic Significance of Fibrinogen Levels in Sepsis-Associated Acute Kidney Injury: Unveiling a Nonlinear Relationship and Clinical Implications

Provisionally accepted
Manqin Chen Manqin Chen 1Xinbin Chen Xinbin Chen 2Huaxiang Ling Huaxiang Ling 3Chengwen Bai Chengwen Bai 1Lihua Chen Lihua Chen 1Lin Zhong Lin Zhong 1Ping Gong Ping Gong 1*Fei Shi Fei Shi 1*
  • 1 Shenzhen People's Hospital, Jinan University, Shenzhen, China
  • 2 Zhuhai International Travel Health Care Center, Zhuhai, China
  • 3 The Second Clinical Medical College, Jinan University, Shen zhen, China

The final, formatted version of the article will be published soon.

    Background: Fibrinogen plays a pivotal role in the inflammatory cascade and is intricately linked to the pathogenesis of sepsis. Nevertheless, its significance as a prognostic marker for sepsis-associated acute kidney injury (SA-AKI) remains uncertain. This study aimed to investigate the association between fibrinogen levels and 28-day mortality with sepsisassociated acute kidney injury.The fibrinogen levels of patients admitted to the intensive care unit of Beth Israel Deaconess Medical Center between 2008 and 2019 were retrospectively assessed, and those diagnosed with SA-AKI were divided into low, middle and high fibrinogen level groups according to tertiles.Multivariate Cox proportional hazards model was used to assess the 28day mortality risk of the SA-AKI patients.Results: A total of 3,479 patients with SA-AKI were included in the study.Fibrinogen demonstrated an independent association with 28-day mortality, yielding a hazard ratio (HR) of 0.961 (95% confidence interval [CI]: 0.923-0.999, P = 0.0471). Notably, a non-linear relationship between fibrinogen levels and 28-day mortality was observed, with the threshold observed at approximately 1.6 g/l. The effect sizes and corresponding CIs below and above this threshold were 0.509 (0.367, 0.707) and 1.011 (0.961, 1.064), respectively. Specifically, the risk of mortality among SA-AKI patients decreased by 49.1% for every 1 g/l increment in fibrinogen, provided that fibrinogen levels were less than 1.6 g/l.In patients with SA-AKI, a non-linear relationship was identified between fibrinogen levels and 28-day mortality. Particularly, when their fibrinogen levels were less than 1.6 g/l, a concomitant decrease in 28-day mortality was observed as fibrinogen levels increased.

    Keywords: Fibrinogen, Sepsis, Acute Kidney Injury, Sepsis-associated acute kidney injury, Mortality, Medical Information Mart for Intensive Care-IV

    Received: 09 Mar 2024; Accepted: 11 Oct 2024.

    Copyright: © 2024 Chen, Chen, Ling, Bai, Chen, Zhong, Gong and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ping Gong, Shenzhen People's Hospital, Jinan University, Shenzhen, China
    Fei Shi, Shenzhen People's Hospital, Jinan University, Shenzhen, China

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