Original Investigations: Pathogenesis and Treatment of Kidney Disease and HypertensionElevated serum levels of the type I and type II receptors for tumor necrosis factor-α as predictive factors for ARF in patients with septic shock★,★★
Section snippets
Methods
We analyzed data from the placebo limb of the Norasept II database. Details of the Norasept II study have been previously published.23
In brief, adults older than 18 years who were admitted to the hospital with septic shock and who met all the following clinical criteria were eligible for enrollment: (1) duration of shock less than 12 hours, (2) clinical evidence of acute infection, (3) core temperature greater than 38.3°C (101°F) or less than 35.6°C (96°F), (4) tachycardia (heart rate > 90
Analysis of entire cohort
To determine factors that correlate with the development of ARF among patients presenting with sepsis and/or SIRS, we retrospectively analyzed multiple routinely available demographic, clinical, and laboratory variables, all obtained at the time of enrollment in a large multicenter study of septic shock.
Five hundred thirty-seven patients were available for analysis, of whom 112 patients (20%) developed ARF. There was no statistically significant difference in causes of septic shock among
Discussion
In this report, we evaluate the association between the development and outcome of ARF with various clinical and laboratory variables, including systemic levels of proinflammatory cytokines, among 537 patients with sepsis and/or SIRS. These patients were enrolled in the placebo arm of the Norasept II study, a multicenter, randomized, double-blind, placebo-controlled trial comparing the administration of antihuman TNF-α mAb with placebo.23 Our most important finding is the significant
Acknowledgements
The authors thank Thomas E. Mansfield III, Senior Clinical Programmer Analyst, Bayer Corp, for invaluable help in preparing the data for analysis.
References (59)
- et al.
Enhanced synthesis of tumor necrosis factor-inducible proteins, plasminogen activator inhibitor-2, manganese superoxide dismutase, and protein 28/5.6 is selectively triggered by the 55-kDa tumor necrosis factor receptor in human melanoma cells
J Biol Chem
(1994) - et al.
A novel domain within the 55 kd TNF receptor signals cell death
Cell
(1993) - et al.
Tumor necrosis factor's cytotoxic activity is signaled by the p55 TNF receptor
Cell
(1993) - et al.
Plasma tumor necrosis factor soluble receptors in chronic renal failure
Kidney Int
(1992) - et al.
Double-blind randomized controlled trial of monoclonal antibody to human tumor necrosis factor in treatment of septic shock
Lancet
(1998) - et al.
Hospital-acquired renal insufficiency: A prospective study
Am J Med
(1983) - et al.
Epidemiology of acute renal failure: A prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group
Kidney Int
(1996) Production and clearance of tumor necrosis factor in rats exposed to endotoxin and dexamethasone
Clin Immunol Immunopathol
(1987)- et al.
Sepsis and cytokines: Current status
Br J Anaesth
(1996) - et al.
Plasma tumor necrosis factor-alpha, its soluble receptors and interleukin-1beta levels in critically burned patients
Burns
(1998)
Tumor necrosis factor-alpha and tumor necrosis factor receptor I, II levels in patients with severe burns
Burns
Elevated levels of soluble tumor necrosis factor receptors are associated with increased mortality rates in patients who undergo operation for ruptured abdominal aortic aneurysm
J Vasc Surg
Early renal ischemia, with or without reperfusion, activates Nfkappa B and increases TNF-alpha bioactivity in the kidney
J Urol
Review article: The role of tumor necrosis factor in renal ischemia-reperfusion injury
J Urol
Inflammatory cytokines and cell response in surgery
Surgery
Acute renal failure in intensive care units—Causes, outcome, and prognostic factors of hospital mortality; A prospective, multicenter study. French Study Group on Acute Renal Failure
Crit Care Med
[Epidemiology and prognosis of acute renal insufficiency]
Nephrologie
Prognostic factors in acute renal failure due to sepsis. Results of a prospective multicentre study. The French Study Group on Acute Renal Failure
Nephrol Dial Transplant
The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group
Kidney Int Suppl
Epidemiology of acute renal failure and outcome of haemodiafiltration in intensive care
Intensive Care Med
Sepsis and serum cytokine concentrations
Crit Care Med
Cytokine serum level during severe sepsis in human IL-6 as a marker of severity
Ann Surg
The pathogenesis of sepsis
Ann Intern Med
Shock and tissue injury induced by recombinant human cachectin
Science
Tumor necrosis factor induces glomerular damage in the rabbit
Am J Pathol
Influence of cytokines on renal circulation and nephron function
Participation of tumor necrosis factor in the mediation of gram negative bacterial lipopolysaccharide-induced injury in rabbits
J Clin Invest
Patterns of cytokine evolution (tumor necrosis factor-alpha and interleukin-6) after septic shock, hemorrhagic shock, and severe trauma
Crit Care Med
Monocyte tumor necrosis factor receptor levels as a predictor of risk in human sepsis
Arch Surg
Cited by (73)
NSC228155 alleviates septic cardiomyopathy via protecting mitochondria and inhibiting inflammation
2023, International ImmunopharmacologyProteomics and Metabolomics for AKI Diagnosis
2018, Seminars in NephrologyCitation Excerpt :Although it is a major mediator in the pathogenesis of numerous conditions causing AKI, it is not considered a specific marker of AKI itself. TNF-α receptors I and II, however, were associated strongly with the development of AKI in a study of septic patients.121 TIMP-2 has a molecular weight of approximately 24 kDa.
Decoding the potential role of regulatory T cells in sepsis-induced immunosuppression
2024, European Journal of Immunology
For the Norasept II Study Investigators.
Supported in part by grants no. DK59793 (J.S.L.) and HL69722 (J.S.L.) from The National Institutes of Health.
- ★
Address reprint requests to Jose Iglesias, DO, 11 Paulette Ln, Howell NJ 07731. E-mail: [email protected]
- ★★
0272-6386/03/4101-0007$35.00/0