(1437) The Dynamic Changes of Gal-3 Predict the Outcome of Septic Acute Kidney Injury

Introduction: Recent research has implicated Galectin-3 (Gal3) in the pathogenesis of acute kidney injury (AKI) during sepsis. However, it is unknown the dynamic changes of gal-3 are related to the progress of septic AKI. This study aimed to investigate the temporal changes in plasma Gal3 levels and the association with the incidence and prognosis of AKI in sepsis patients and rat.

Methods: We prospectively observed a cohort comprising 27 healthy controls and 87 sepsis patients. In the sepsis patient, the dynamic changes in Gal3 levels were closely monitored during the initial three days following diagnosis. To further investigate the significance of Gal3 in sepsis-associated AKI, a rat model was induced through cecal ligation and puncture (CLP). The study meticulously assessed 7-day mortality and serum levels of Gal-3, Interleukin-6 (IL-6), and creatinine at 1-,3-, and 24-hours post-CLP.To assess the potential therapeutic effects of Gal3 adsorption, the rats were divided into two groups. One group (n=28) received plasma Gal3 adsorption, while the second group (n=20) underwent sham plasma Gal3 adsorption.

Results: Septic patients exhibited significantly elevated levels of Gal-3 and IL-6 in serum at all time points compared to the healthy controls(all P< 0.001). The subsequent AKI group exhibited significantly higher levels of Galectin-3 in the serum on days 1,2, and 3. The serum concentrations of Gal-3 in survived septic patients exhibited a rapid decrease, reaching significantly lower levels than those in non-survived septic patients (P < 0.01). In the rat model, the plasma Gal-3, IL-6, and Cr levels in the blood adsorption group were lower than those in the sham group at 3 h and 24 h (all P< 0.05). Survival analysis of the two groups of rats revealed that serum Gal-3 adsorption significantly reduced the mortality (42.9% vs 75%), and there was also a significant reduction in the incidence of AKI in rats by apheresis (28.6% vs 50%).

Conclusions: The findings suggest that monitoring the dynamic changes of plasma Gal3 levels in sepsis patients during the early phases of hospitalization may serve as a potential predictive indicator of AKI development and prognosis. Furthermore, blood adsorption of Gal3 could emerge as a promising therapeutic approach for preventing and managing AKI in the context of sepsis.