Péter Kustán, Balázs Szirmay, Zoltán Horváth-Szalai, Andrea Ludány, Gábor L Kovács, Attila Miseta, Tamás Kőszegi, Diána Mühl
Clinical chemistry and laboratory medicine 2017 Feb 01In order to help clinical decision making, we investigated the diagnostic and prognostic ability of urinary orosomucoid (u-ORM) as a new sepsis biomarker, and compared its performance to classical inflammatory parameters. We monitored u-ORM in septic (n=43) and SIRS (n=13) patients in a 5-day follow-up study vs. control patients (n=30). U-ORM was measured by a newly developed turbidimetric assay. U-ORM values were referred to urinary creatinine and expressed as u-ORM/u-CREAT (mg/mmol). Significantly higher (p<0.001) u-ORM/u-CREAT levels were found in sepsis than in SIRS. Both intensive care unit (ICU) groups showed strongly elevated values compared to controls (p<0.001). The medians of admission u-ORM/u-CREAT levels were 19.2 in sepsis, 2.1 in SIRS and 0.2 mg/mmol in controls. The area under the receiver operating characteristic curve for distinguishing SIRS from sepsis was found to be 0.954 for u-ORM/u-CREAT, superior to serum ORM and hsCRP. U-ORM levels did not change during the 5-day follow-up and were independent of the severity of sepsis however, we found extremely elevated u-ORM/u-CREAT values in dialyzed septic patients (52.2 mg/mmol as median). The early and relevant increase of u-ORM in sepsis suggests that it might be a promising novel marker of sepsis and could be a valuable part of routine laboratory and clinical practice.
Péter Kustán, Balázs Szirmay, Zoltán Horváth-Szalai, Andrea Ludány, Gábor L Kovács, Attila Miseta, Tamás Kőszegi, Diána Mühl. Urinary orosomucoid: a novel, early biomarker of sepsis with promising diagnostic performance. Clinical chemistry and laboratory medicine. 2017 Feb 01;55(2):299-307
PMID: 27816958
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