Soluble Urokinase Plasminogen Activator Receptor as an Early Detector of Acute Kidney Injury in Critically Ill Patients

Abdel Moniem, Mohammed Attia; Ghorab, Adel A.M.; Al- Barshomy, Said M.; Abd El Hameed, Abdullah Mohamed; Elsayed, Raghda Yehia; Abdelrahim, Mohamed Gomaa

doi:10.21608/zumj.2025.414693.4116

Soluble Urokinase Plasminogen Activator Receptor as an Early Detector of Acute Kidney Injury in Critically Ill Patients

Document Type : Original Article

Authors

¹ Lecturer of Internal Medicine, Faculty of Medicine - Zagazig University

² Professor of Internal Medicine and Nephrology, Faculty of Medicine - Zagazig University

³ Lecturer of Clinical Pathology, Faculty of Medicine - Zagazig University

⁴ Nephrology Resident in 6th October Health Insurance Hospital

10.21608/zumj.2025.414693.4116

Abstract

Background: Acute kidney injury (AKI) remains a prevalent complication among critically ill patients and is linked with higher rates of morbidity in addition to mortality. Soluble urokinase plasminogen activator receptor (suPAR) has emerged as a potential early biomarker, but its predictive value remains uncertain. We aimed to evaluate the role of suPAR for early detection of AKI among critically ill patients with also exploring its potential in improving clinical outcomes.

Methods: We did this prospective observational cohort research on 32 ICU patients categorized into AKI (n = 19) and non-AKI (n = 13) groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Serum suPAR was measured at admission (0 h), 24 h, and 48 h.

Results: Neurological deficits were more prevalent among AKI patients (72.7% vs. 27.3%, p = 0.023). Potassium, serum creatinine, as well as BUN at 24,48 hours were significantly higher in AKI patients (all p < 0.005). APACHE II scores were also elevated (17.53 vs. 12.31, p = 0.036). suPAR levels were slightly higher at 24 h and 48 h but not significant, though they correlated with creatinine at 24 h (r = 0.379, p = 0.032), WBCs (r = –0.409, p = 0.02), and albumin (r = –0.353, p = 0.047).

Conclusion: suPAR levels were not independently predictive of AKI among critically ill ICU patients, whereas conventional clinical scores and renal function tests remained more reliable predictors. Combining suPAR with other biomarkers may enhance early AKI risk stratification.

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