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Cited by 19Sepsis Diagnosis and TreatmentInflammation biomarkers and pathwaysAcute Kidney Injury Research

Soluble urokinase plasminogen activator receptor (suPAR) predicts critical illness and kidney failure in patients admitted to the intensive care unit

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Reisinger, Alexander C., Niedrist, Tobias, Posch, Florian, Hatzl, Stefan, Hackl, Gerald, Prattes, Juergen, Schilcher, Gernot, Meißl, Anna-Maria +3 more·2021·Scientific Reports
DOI 10.1038/s41598-021-96352-1PMC PMC8410930
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Abstract

Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker and risk factor for kidney diseases, with a potential prognostic value in critically ill patients. In this monocentric prospective study, we measured plasma suPAR levels immediately after ICU admission in unselected 237 consecutive patients using a turbidimetric assay. Primary objective was the prognostic value for ICU- and 28-day mortality. Secondary objectives were association with sequential organ failure assessment (SOFA) score, coagulation and inflammation markers, AKI-3 and differences in prespecified subgroups. Median suPAR levels were 8.0 ng/mL [25th-75th percentile 4.3–14.4], with lower levels in ICU survivors than non-survivors (6.7 vs. 11.6 ng/mL, p < 0.001). SuPAR levels were higher in COVID-19, kidney disease, moderate-to-severe liver disease, and sepsis. ICU mortality increased by an odds ratio (OR) of 4.7 in patients with the highest compared to lowest quartile suPAR. Kaplan–Meier overall survival estimates at 3 months were 63% and 49%, in patients with suPAR below/above 12 ng/mL (log-rank p = 0.027). Due to an observed interaction between SOFA score and suPAR, we performed a random forest method identifying cutoffs. ICU mortality was 53%, 17% and 2% in patients with a SOFA score > 7, SOFA ≤ 7 & suPAR > 8 ng/mL, and SOFA score ≤ 7 & suPAR ≤ 8 ng/mL, respectively. suPAR was a significant predictor for AKI-3 occurrence (OR per doubling 1.89, 95% CI: 1.20–2.98; p = 0.006). suPAR levels at ICU admission may offer additional value for risk stratification especially in ICU patients with moderate organ dysfunction as reflected by a SOFA score ≤ 7.

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  • Several putatively impacted proteins are potential biomarkers or drug targets (for example, suPAR and PILRA).

    “It remains challenging to establish the pervasiveness of assay-interference effects; however, we note that several putatively impacted proteins are potential biomarkers or drug targets (for example, suPAR32,33 and PILRA27).”

    From Cross-ancestry comparison of aptamer and antibody protein measures (2026) · cites this paper as [32]

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Cited by

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Authors
Reisinger, A. C., Niedrist, T., Posch, F., Hatzl, S., Hackl, G., Prattes, J., Schilcher, G., Meißl, A.-M., Raggam, R. B., Herrmann, M., & Eller, P.
Affiliations
Medical University of Graz (AT)
Corresponding author
Eller, Philipp
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2021-09-01
Volume
11
Issue
1
Pages
17476-17476
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-021-96352-1
PMC
PMC8410930
OpenAlex
W3197594066
Cited by
19
References
1
Citations by year
2026: 4 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 5
FWCI
2.16
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
  • Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
Keywords
soluble urokinase plasminogen activator receptor, suPAR, critically ill patients, intensive care unit admission, ICU mortality, acute kidney injury, prognostic factors, SOFA score, risk stratification, COVID-19 pandemic, sepsis, liver disease, inflammatory markers, coagulation markers
MeSH terms
Immunoturbidimetry, COVID-19, Aged, Female, Humans, Intensive Care Units, Kidney Diseases, Male, Middle Aged, Mortality, Prognosis, Prospective Studies, Odds Ratio, Survival Analysis, Critical Illness, Renal Insufficiency, Receptors, Urokinase Plasminogen Activator, Organ Dysfunction Scores

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