Endothelial biomarkers as predictors for haemodialysis need in severe leptospirosis patients (Weil's disease).

Abstract

OBJECTIVE:

To investigate the prediction ability of vascular injury biomarkers for haemodialysis requirement in patients with severe leptospirosis.

METHODS:

Prospective study with severe leptospirosis patients hospitalised in Fortaleza, Brazil. Blood samples were collected hospital admission to quantify vascular injury biomarkers: syndecan-1, ICAM-1, VCAM-1, angiopoietin-2 and FGF-23. Two groups were evaluated according to haemodialysis requirement during hospital stay.

RESULTS:

Twenty-seven patients were included, with a mean age of 39 ± 18 years. 88.9% were males. 53.8% needed haemodialysis and presented higher levels on hospital admission of syndecan-1 (572 [300-811] vs. 263 [106-421] ng/ml; p = 0.03), angiopoietin-2 (1.52 [0.72-2.72] vs. 0.63 [0.4-1.38] ng/ml; p = 0.01), and FGF-23 (291 [56-2031] vs. 10 [10-806] pg/ml; p = 0.021). Syndecan-1 showed significant correlation with creatinine (r = 0.546; p = 0.05) and total bilirubin levels (r = 0.534; p = 0.013) on hospital admission. Angiopoietin-2 showed significant correlation with creatinine levels (r = 0.513; p = 0.009) on hospital admission and with number of haemodialysis sessions (r = 0.406; p = 0.049). No significant correlation was found with FGF-23. Regarding prognostic performance, combined syndecan-1 and angiopoietin-2 levels had a better ability to predict haemodialysis need in patients with severe leptospirosis (AUC-ROC = 0.744 [95% CI: 0.545-0.943] p = 0.035).

CONCLUSION:

Syndecan-1 and angiopoietin-2 were associated with haemodialysis need in patients with severe leptospirosis and may be useful to improve therapeutic approach and reduce mortality.

• Authors: Gdayllon Cavalcante Meneses, Pedro Eduardo Andrade de Carvalho Gomes, Gabriela Studart Galdino, Gabriela Freire Bezerra, Ranieri Sales de Souza Santos, Alice Maria Costa Martins, Geraldo Bezerra da Silva Junior, Alexandre Braga Libório, Roberto da Justa Pires Neto, Elizabeth De Francesco Daher
• Journal: Tropical medicine & international health : TM & IH (Trop Med Int Health) Vol. 27 Issue 8 Pg. 727-734 (08 2022) ISSN: 1365-3156 [Electronic] England
• PMID: 35761507 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2022 John Wiley & Sons Ltd.

Chemical References

• Angiopoietin-2
• Biomarkers
• Syndecan-1
• Creatinine

Topics

• Adult
• Angiopoietin-2 (therapeutic use)
• Biomarkers
• Creatinine (therapeutic use)
• Female
• Humans
• Leptospirosis
• Male
• Middle Aged
• Prospective Studies
• Renal Dialysis
• Syndecan-1 (therapeutic use)
• Vascular System Injuries (complications)
• Weil Disease (complications)
• Young Adult