Kidney Week

Abstract: FR-PO0389

Plasma Complement Factor Ba Is Elevated in Critically Ill Children with Sepsis-Associated AKI

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

• Stenson, Erin K., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Erin K. Stenson, MD

• Ernest, Emily P., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Emily P. Ernest, MD

• Leroue, Matthew, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Matthew Leroue, MD

• Wilson, Patrick T., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Patrick T. Wilson, MD

• Maddux, Aline B., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Aline B. Maddux, MD, MSc

• Kendrick, Jessica B., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Jessica B. Kendrick, MD, MPH

Background

Critically ill children with sepsis associated acute kidney injury (SAAKI) have high morbidity and mortality rates and lack treatment options. The alternative complement pathway has been implicated in AKI pathogenesis and complement targeted therapeutics exist. We aimed to determine if plasma Ba, an activation fragment of the alternative complement pathway, was elevated in critically ill children with SAAKI.

Methods

Septic children who were admitted to the pediatric intensive care unit (PICU) at Children’s Hospital Colorado and did not have rheumatologic disease or dialysis dependence were consented and enrolled. Day 1 urine and plasma were obtained, processed, frozen at -80°C, and Ba was quantified by ELISA. AKI was staged based on KDIGO serum creatinine (sCr) criteria compared to baseline. If no prior baseline, sCr was estimated using a presumed normal glomerular filtration rate of 120 ml/min/1.73 m². Primary outcome was maximum AKI stage within first 7 days of ICU admission. T-test was used to determine differences between groups.

Results

75 children were included of which 59 (79%) had no AKI and 16 (21%) had stage 3 AKI (Table 1). Plasma Ba was significantly higher in patients with stage 3 AKI (median 1029 ng/mL; IQR 840-2007) compared to patients without AKI (median 772 ng/mL; IQR 612, 966); p<0.001; Figure 1. Similar results were seen with urine Ba and a combined measure of urine Ba/plasma Ba. Urine Ba/plasma Ba was significantly higher in patients with stage 3 AKI (median 1870; IQR 907-2407) compared to patients without AKI (median 120; IQR 33, 441); p 0.0016).

Conclusion

Overall, plasma Ba is significantly increased in patients with stage 3 AKI compared to patients without AKI. Urine and plasma Ba may be helpful for prognostic and predictive enrichment of future clinical trials of complement inhibition to treat or prevent SA-AKI in critically ill children.

Funding

• NIDDK Support