Changes in plasma kynurenic acid concentration in septic shock patients undergoing continuous veno-venous haemofiltration

Inflammation. 2014 Feb;37(1):223-34. doi: 10.1007/s10753-013-9733-9.

Abstract

Kynurenic acid (KYNA) is one of the end products of tryptophan metabolism. The aim of this study was to analyse plasma KYNA concentration in septic shock patients (SSP) with acute kidney injury (AKI) undergoing continuous veno-venous haemofiltration (CVVH). Changes in KYNA content were compared to alterations in the levels of procalcitonin (PCT), C-reactive protein and lactate. Adult SSP with AKI were examined. Measurements were conducted at seven time points: before beginning CVVH and at 6, 12, 24, 48, 72 and 96 h after the beginning of CVVH. Based on clinical outcomes, the data were analysed separately for survivors and non-survivors. Twenty-seven patients were studied. CVVH was associated with reduced plasma KYNA concentration only in survivors. Plasma KYNA concentration correlated with the levels of lactate and PCT only in survivors. (1) CVVH reduced plasma KYNA concentration only in survivors; (2) lack of this reduction may predict fatal outcomes in SSP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / blood*
  • Bacterial Infections / blood
  • Bacterial Infections / microbiology
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Female
  • Hemofiltration / adverse effects
  • Humans
  • Kynurenic Acid / blood*
  • Lactic Acid / blood
  • Male
  • Middle Aged
  • Multiple Organ Failure / blood
  • Mycoses / blood
  • Mycoses / microbiology
  • Protein Precursors / blood
  • Pyometra / blood
  • Pyometra / microbiology
  • Shock, Septic / blood*
  • Shock, Septic / microbiology
  • Shock, Septic / mortality
  • Treatment Outcome
  • Urinary Tract Infections / blood
  • Urinary Tract Infections / microbiology

Substances

  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Lactic Acid
  • Calcitonin
  • C-Reactive Protein
  • Kynurenic Acid
  • Calcitonin Gene-Related Peptide