Value of Serum Thrombomodulin as a Marker and Predictor in Patients with Sepsis-Associated Acute Kidney Injury

Van Tri Nguyen,1,2 Hong Ngoc Nguyen-Phan,1 That Ngoc Ton,3 Bui Bao Hoang1 1Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam; 2Department of Anesthesiology of Hue International Medical Center, Hue Central Hospital, Hue City, Vietnam; 3Department of Biochemistry, Hue Central Hospital, Hue City, VietnamCorrespondence: Bui Bao Hoang, Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, Vietnam, Tel +84905405005, Email [email protected]; [email protected]: To investigate the serum soluble thrombomodulin (sTM) concentration in patients with sepsis-associated acute kidney injury (AKI) and to determine the value of sTM in predicting AKI and mortality in sepsis patients.Methods: This prospective observational study was conducted on 71 patients diagnosed with sepsis according to Sepsis 3 at the Intensive Care Unit, Hue Central Hospital, Vietnam, from September 2021 to February 2023.Results: Among 71 sepsis patients, there were 38 (53.5%) AKI cases, including 16 (22.5%) cases of stage 1 AKI, 14 (19.7%) cases of stage 2 AKI, 8 (11.3%) cases of stage 3 AKI, 16 (22.5%) cases of renal replacement therapy, 28 (39.4%) cases of septic shock, and 21 (29.6%) cases of mortality within 28 days. The concentrations of lactate and IL-6 in the AKI and mortality groups were statistically significantly greater than those in the non-AKI and survival groups (p < 0.05). The serum sTM concentration was 4.33 ng/mL, the serum sTM level in the AKI group was statistically significantly higher than that in the non-AKI group (sTM [4.71 vs 2.54 ng/mL, p < 0.001]), and the serum sTM level in the mortality group was statistically significantly higher than the survival group (sTM [4.78 vs 3.87 ng/mL, p < 0.001]). The AUC of sTM for predicting AKI was 0.864; the AUCs of sTM, IL-6, SOFA, and APACHE II for predicting mortality were 0.811, 0.671, 0.816, and 0.705, respectively.Conclusion: AKI was a prevalent complication among sepsis patients at the ICU. In the AKI and mortality groups, sTM concentration was statistically significantly higher than that in the non-AKI and survival groups. sTM was the predictor of acute kidney injury and mortality in patients with sepsis.Keywords: thrombomodulin, sepsis, acute kidney injur

Calcium Requirement and Vitamin D Supplementation in Meat-Type Quail at First Stage of Growth

ABSTRACT Currently, feed formulations for quail are based on foreign data or data from other species; this undermines productivity with the use of excessive or deficient levels of some nutrients. Therefore, this study aimed to determine the nutritional requirement levels of calcium (Ca) and supplementation vitamin D in meat-type quail from 1 to 14 d of age. The experiment was a 4 × 4 factorial arrangement of treatments (levels of Ca: 0.42, 0.58, 0.74 and 0.90% and levels of vitamin D: 1,000, 2,000, 3,000 and 4,000 IU) with 3 replicate pens and 43 quails per pen. Weight gain increased quadratically with increased levels of Ca and vitamin D; this variable yielded estimated levels of 0.73% Ca and 2,883 IU vitamin D. There was no Ca x vitamin D interaction effect on bone variables. Bone Ca, bone phosphorus, bone ash, femoral bone strength, tibial bone strength and the femoral Seedor index increased quadratically with an increase in Ca levels. These variables yielded estimated values of 0.78, 0.71, 0.78, 0.77, 0.83, and 0.71% Ca, respectively. It is concluded that the requirements of Ca and vitamin D for the maximum weight gain of meat-type quails, in the period from one to 14 days of age, were 0.73% Ca (p=0.001) and 2,883 IU vitamin D (p=0.02), respectively.</div