Abstract
AIM: To investigate the dynamics of serum amyloid A (SAA) and procalcitonin (PCT) in sepsis-associated acute kidney injury (SAKI) and to evaluate their prognostic value for renal outcomes. METHODS: 159 Emergency Intensive Care Unit (EICU) patients with SAKI were enrolled. Serum SAA and PCT levels were measured on days 1, 3, 5, and 7 after enrollment. Patients were stratified by 28d renal recovery status. Associations with renal outcomes and predictive performance were examined using Pearson correlation, multivariable logistic regression and receiver operating characteristic (ROC) curve analysis. RESULTS: Non-recovery was associated with higher baseline levels of SAA, PCT, lactate, serum creatinine, and APACHE II scores (all p < 0.05). Both biomarkers declined progressively, reaching their lowest levels by day 7. Baseline SAA and PCT showed strong negative correlations with 28d eGFR (r = -0.414, -0.491; p < 0.05). Multivariable logistic regression identified APACHE II score (OR = 1.260), SAA (OR = 1.025), and PCT (OR = 1.275) as independent predictors of non-recovery. ROC curve analysis demonstrated good discriminative ability, with AUCs of 0.813 for SAA, 0.819 for PCT, and 0.827 for APACHE II (all p < 0.05). CONCLUSION: SAA and PCT are robust short-term predictors of renal outcomes in sepsis-associated AKI. Their dynamic trajectories reflect disease severity and treatment response.