Prognosis of critically ill patients with severe acute kidney injury and high circulating dipeptidyl peptidase 3: a post hoc analysis of the AKIKI 2 trial

Crit CarePublished Secondary analysis of the AKIKI 2 randomised trial

Primary result · 28-day mortalityResult — go to the resultHazard ratio 1.95 95% CI 1.37–2.87

Authors' conclusion

In critically ill patients with severe AKI, a high cDPP3 concentration at diagnosis is associated with increased short-term mortality and prolonged dependence on organ support.

Study context

Population
ICU patients with severe acute kidney injury (AKI) (KDIGO stage 3) receiving (or having received) invasive mechanical ventilation and/or vasopressor support, with blood samples at inclusion
Participants
287 patients
Comparison
High vs low circulating DPP3
  • High cDPP3n = 143
Primary endpoint
28-day mortality
Follow-up
28 days
Methodological detailspost hoc analysis, predefined cutoff
  • Post hoc analysis
  • Predefined cutoff

Primary result

As reported in the abstract

Hazard ratio

1.95

95% CI 1.37–2.87

P < 0.001

High cDPP3 vs Low cDPP3
HR 1.95 (95% CI 1.37–2.87); P < 0.001

Secondary outcomes

OutcomeMean difference (95% CI)P value
Days alive without vasopressorsHigh cDPP3 vs Low cDPP3- 5.59 (- 8.29 to - 2.78)P < 0.001
Days alive without invasive mechanical ventilationHigh cDPP3 vs Low cDPP3- 6.23 (- 8.89 to - 3.36)P < 0.001
Days alive without RRTHigh cDPP3 vs Low cDPP3- 6.35 (- 9.14 to - 3.26)P < 0.001

Organ support-free days, adjusted for baseline severity

Association remained significant after adjustment

Original publication

Prognosis of critically ill patients with severe acute kidney injury and high circulating dipeptidyl peptidase 3: a post hoc analysis of the AKIKI 2 trial. Crit Care. Published 3 March 2026. doi:10.1186/s13054-026-05910-4

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