The role of phospholipid transfer protein in sepsis-associated acute kidney injury
Authors' conclusion
These findings indicate that PLTP is a potential therapeutic target in sepsis-associated acute kidney injury.
Study context
- Population
- ICU patients with sepsis52 developed acute kidney injury (AKI)
- Participants
- 93 patients
- Exposure
- High vs low plasma phospholipid transfer protein (PLTP) lipotransfer activity
- Outcome
- Incidence of SA-AKI and 30-day major adverse kidney events (MAKE 30)
Methodological detailspopulation-based, mouse cecum ligation and puncture (CLP) model
- Population-based
- Mouse CLP model
Main finding
As reported in the abstract
PLTP lipotransfer activity as predictor of SA-AKI and MAKE 30
Estimate (95% CI)P value
PLTP lipotransfer activity
crude OR (SA-AKI) 0.96(0.95–0.98)
P < 0.001PLTP lipotransfer activity
adjusted OR (SA-AKI) 0.92(0.86–0.96)
P = 0.001PLTP lipotransfer activity
crude OR (MAKE 30) 0.97(0.96–0.98)
P < 0.001PLTP lipotransfer activity
adjusted OR (MAKE 30) 0.96(0.93–0.98)
P = 0.001Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Cumulative incidence of MAKE 30 (Kaplan-Meier) · 30 daysSignificantly lower in high group | P < 0.001 |
Prediction of sepsis-associated acute kidney injury (SA-AKI) and MAKE 30 by PLTP activity within 24 h of ICU admission (AUC)
- AUC for SA-AKI
- 0.87 (95% CI 0.79-0.94)
- AUC for MAKE 30
- 0.87 (95% CI 0.80-0.94)
30-day outcomes, whole cohort
- Died
- 32
- Kidney replacement therapy
- 34
- Persistent AKI
- 37
- Met composite endpoint
- 55
Mouse CLP model
- CLP mice: creatinine significantly elevated and PLTP activity significantly decreased at 24 h vs controls
- PLTP ± mice: significantly impaired renal function and elevated inflammatory mediators vs wild-type CLP mice
- Recombinant human PLTP prolonged 10-day survival, improved renal function, attenuated mitochondrial damage in wild-type CLP mice
Original publication
The role of phospholipid transfer protein in sepsis-associated acute kidney injury. Crit Care. Published 20 January 2025. doi:10.
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