Abstract
Background:
In order to help clinical decision making, we investigated the diagnostic and prognostic ability of urinary orosomucoid (u-ORM) as a new sepsis biomarker, and compared its performance to classical inflammatory parameters.
Methods:
We monitored u-ORM in septic (n=43) and SIRS (n=13) patients in a 5-day follow-up study vs. control patients (n=30). U-ORM was measured by a newly developed turbidimetric assay. U-ORM values were referred to urinary creatinine and expressed as u-ORM/u-CREAT (mg/mmol).
Results:
Significantly higher (p<0.001) u-ORM/u-CREAT levels were found in sepsis than in SIRS. Both intensive care unit (ICU) groups showed strongly elevated values compared to controls (p<0.001). The medians of admission u-ORM/u-CREAT levels were 19.2 in sepsis, 2.1 in SIRS and 0.2 mg/mmol in controls. The area under the receiver operating characteristic curve for distinguishing SIRS from sepsis was found to be 0.954 for u-ORM/u-CREAT, superior to serum ORM and hsCRP. U-ORM levels did not change during the 5-day follow-up and were independent of the severity of sepsis however, we found extremely elevated u-ORM/u-CREAT values in dialyzed septic patients (52.2 mg/mmol as median).
Conclusions:
The early and relevant increase of u-ORM in sepsis suggests that it might be a promising novel marker of sepsis and could be a valuable part of routine laboratory and clinical practice.
Acknowledgments
The present scientific contribution is dedicated to the 650th anniversary of the foundation of the University of Pécs, Hungary. Hereby we express our special thanks for the invaluable help of our nurses and colleagues. We are grateful for Dako A/S Company for providing us the ORM reagents and for Roche Magyarország Kft for the opportunity and technical support of using a developmental channel in our measurements.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: The work was supported by GINOP-2.3.2-15-2016-00021 and NKFI-EPR K/115394/2015 grants.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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