The value of combining mir-10a-5p levels and plr to evaluate the prognosis of sepsis patients with acute kidney injury

Objective: To determine the value of combining miR-10a-5p levels and PLR to evaluate the prognosis of sepsis patients with acute kidney injury (AKI). Methods: A total of 142 patients with sepsis admitted to SICU in our hospital from September 2018 to September 2019 were included in this study. The patients were divided according to presence of an AKI into an observation group (n = 62, sepsis with AKI) and a control group (n = 80, sepsis without AKI). The observation group was then divided into a survival group (n = 40) and death group (n = 22), according to the prognosis of the patients. 5ml of fasting venous blood was collected from all patients in the morning, and sent to the lab for analysis. The serum level of miR-10a-5p was determined using PT-PCR, while platelet count (PLT) and lymphocyte count (LYM) were automatically detected using a blood analyzer, and the platelet/ lymphocyte value (PLR) was calculated. Serum creatinine (Scr) and cystatin (Cys-C) levels were determined using the microparticle enzyme-free analyzer, and kidney injury molecule 1 (KIM-1) levels were measured with an enzyme-linked immunosorbent assay. The levels of miR-10a-5p, PLR, Scr, Cys-C, and KIM-1 of each group were compared, and the independent risk factors for the prognosis of AKI in sepsis were analyzed using multi-element logistic regression. miR-10a-5p was analyzed using a ROC curve combined with the PLR to evaluate the prognostic value of patients with sepsis acute kidney injury. Results: The serum levels of miR-10a-5p and PLR in the observation group were significantly higher than those in the control group, and the difference was statistically significant (P< 0.05). The serum levels of miR-10a-5p and PLR in the death group were significantly higher than those in the survival group, and this was also statistically significant (P < 0.05). The serum levels of Scr, Cys-C and KIM-1 in the observation group were significantly higher than those in the control group, and the difference was statistically significant (P< 0.05). The serum levels of Scr, Cys-C and KIM-1 in the death group were significantly higher than those in the survival group, and the difference was statistically significant (P < 0.05). Multi-element logistic regression analysis showed that miR-10a-5p, PLR, Scr, and Cys-C were all independent risk factors for the prognosis of sepsis patients with sepsis. ROC curve analysis showed that the AUC for PLR as a prognosticator for sepsis patients with AKI was 0.767, and the best diagnostic value was 119 (sensitivity 70.36%, specificity 71.21%). In addition, the AUC for miR-10a-5p as a prognosticator for sepsis patients with AKI was 0.805, and the best diagnostic value was 1.35 (sensitivity 79.14%, specificity 77.89%). The combined AUC for miR-10a-5p and PLR as prognosticators was 0.902 (sensitivity 88.15%, specificity 86.41%). Conclusion: The serum miR-10a-5p levels and PLR of patients with sepsis and AKI are raised, and this has potential value for use in estimating the prognosis of these patients. The diagnostic value is greatest when these factors are taken in combination.