Diagnostic Value of Proenkephalin A 119 – 159 Serum in Early Detection of Sepsis Associated Acute Kidney Injury

Adefri Wahyudi; Drajad Priyono; Harnavi Harun; Deka Viotra; Najirman Najirman; Roza Kurniati; Rohayat Bilmahdi Simajuntak; Arina Widya Murni

doi:10.32867/inakidney.v3i1.239

Adefri Wahyudi Internal Medicine, Faculty of Medicine General Hospital Dr. M Djamil Padang
Drajad Priyono Division of Nephrology and Hypertension
Harnavi Harun
Deka Viotra
Najirman Najirman
Roza Kurniati
Rohayat Bilmahdi Simajuntak
Arina Widya Murni

DOI: https://doi.org/10.32867/inakidney.v3i1.239

Keywords: Sepsis, Acute Kidney Injury, Proenkephalin A 119-159, PENK

Abstract

Background: Sepsis asscociated acute kidney injury (SA-AKI) is common condition that found in sepsis. Due to the lack of creatinine serum, this condition possibly makes therapy delayed. Proenkephalin A 119-159 (PENK) is a breakdown product of the prohormone proenkephalin A which freely filtered at the glomerulus. In other hand, this prohormone and its receptor predominantly expressed in proximal Tubular Epythelial Cells (pTEC) of kidney. Elevated serum PENK levels are an indicator of AKI. However, previous studies have shown varies results.

Objectives: This study aims to determine early detection biomarkers for the presence of AKI in sepsis.

Methods: This diagnostic test was conducted at Dr. M. Djamil General Hospital Padang in sepsis patients. The diagnosis of AKI was established based on the 2012 KDIGO criteria.

Results: The study involved 98 sepsis patients, 58.16% (n=57) of them experienced AKI. Serum creatinine levels at admission and within 48 hours of hospitalization were 1.0 (IQR 0.8–1.5) mg/dl and 1.6 (IQR 0.9–2.1) mg/dl, respectively. A serum PENK level ≥82.6 pmol/L at admission had sensitivity of 98.6%, specificity of 95.1%, positive predictive value of 96.1%, negative predictive value of 97.5%, and accuracy of 96.9% in early detection of AKI in sepsis.

Conclusion: Serum PENK level has excellent diagnostic value in early detection of AKI in sepsis.

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Author Biographies

Drajad Priyono, Division of Nephrology and Hypertension

Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Universitas Andalas/ RSUP DR.M.Djamil Padang

Harnavi Harun

Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Universitas Andalas/ RSUP DR.M.Djamil Padang

Deka Viotra

Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Universitas Andalas/ RSUP DR.M.Djamil Padang

Najirman Najirman

Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Universitas Andalas/ RSUP DR.M.Djamil Padang

Roza Kurniati

Department of Internal Medicine, Division of Pulmonology, Faculty of Medicine, Andalas University /RSUP Dr. M. Djamil General Hospital, Padang, Indonesia

Rohayat Bilmahdi Simajuntak

Department of Internal Medicine, Division of Tropical Medicine and Infection , Faculty of Medicine, Universitas Andalas/ RSUP DR.M.Djamil Padang

Arina Widya Murni

Department of Internal Medicine, Division of Psychosomatics and Rehabilitation, Faculty of Medicine, Universitas Andalas/ RSUP DR.M.Djamil Padang

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