Kidney Week

Abstract: FR-PO0388

Longitudinal Plasma and Urinary Biomarkers for Predicting Acute Kidney Disease in Patients with Sepsis-Associated AKI: A Prospective Cohort Study

Session Information

• AKI: Biomarkers, Diagnostics, and Risk Prediction
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Lee, Ha-Eun, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

Ha-Eun Lee, MD

• Jeong, Seung Hee, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

Seung Hee Jeong, MD

• Cho, A young, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

A young Cho, MD

• Oh, Ju hwan, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

Ju hwan Oh, MD

• Sun, In O, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

In O Sun, MD, PhD

• Shin, Kwang-Hee, Kyungpook National University, Daegu, Korea (the Republic of)

Kwang-Hee Shin, PhD, RPh

• Kang, Kyung Pyo, Jeonbuk National University, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

Kyung Pyo Kang, MD, PhD

Background

Sepsis-associated acute kidney injury (SA-AKI) frequently progresses to acute kidney disease (AKD), a critical transition phase toward chronic kidney disease (CKD). As validated predictors for the transition from SA-AKI to AKD remain limited, we evaluated longitudinal plasma and urine biomarkers for predicting AKD following SA-AKI.

Methods

This prospective study included 50 adults with SA-AKI (defined by Sepsis-3 and Kidney Disease: Improving Global Outcomes criteria). Patients with end-stage kidney disease, prior kidney transplantation, or baseline estimated glomerular filtration rate < 45 mL/min/1.73m² were excluded. Plasma and urine samples were collected at 0, 6, and 48 hours after diagnosis. The primary outcome was AKD development at Day 7, defined by the 16^th Acute Disease Quality Initiative consensus.

Results

The cohort had a median age of 77 years (52.0% male) and 17 (34.0%) had pre-existing CKD. AKD developed in 17 (34.0%) patients, while the remaining 33 (66.0%) recovered without AKD. Among longitudinal biomarkers of tubular injury, glomerular filtration, and glomerular injury, the discriminatory performance generally improved over 48 hours (Figure 1). Plasma neutrophil gelatinase-associated lipocalin (NGAL) measured at 48 hours demonstrated the highest area under the receiver operating characteristic curve (0.859; 95% confidence interval, 0.752–0.965, P<0.001).

Conclusion

Among evaluated biomarkers, plasma NGAL measured at 48 hours post-diagnosis demonstrated the highest discriminatory performance for AKD progression following SA-AKI.

Figure 1. Receiver operating characteristic curves of (A) plasma NGAL, (B) urine NGAL/creatinine, (C) plasma cystatin C, and (D) urine albumin/creatinine for AKD prediction at 0, 6, and 48 hours post-diagnosis. AUC, area under the curve.

Funding

• Private Foundation Support