Abstract: Objective  To explore the relationship between serum a proliferation-inducing ligand (APRIL) level and sepsis-induced acute kidney injury.  Methods  A total of 106 patients with sepsis admitted to Baoding First Central Hospital from October 2020 to October 2021 were selected. Fasting venous serum samples were collected from patients at admission, and serum APRIL was measured by enzyme-linked immunosorbent assay. According to the median serum APRIL level of 13.42 (7.38, 19.65) μg/L, the patients were divided into high APRIL group (n=43) and low APRIL group (n=63). The relationship between serum APRIL level and sepsis-induced acute kidney injury was analyzed.  Results  Gender, age, white blood cell count, C-reactive protein, procalcitonin, cystatin C, creatinine clearance rate, APACHE Ⅱscore, mechanical ventilation, renal replacement therapy, and serum APRIL level were significantly different between high APRIL group and low APRIL group (χ2=4.068, t=2.678, 2.746, 9.816, 18.915, 12.515, 6.021, 10.130, 19.063, 9.012 and 3.176 respectively; P≤0.05, 0.044, 0.009, 0.007, <0.001, <0.001, <0.001, <0.001, <0.001, 0.003 and <0.001 respectively). The incidence of acute kidney injury was 39.53% in high APRIL group and was 19.05% in low APRIL group ( χ2=5.398, P=0.000), suggesting that serum APRIL level is correlated with    sepsis-induced acute kidney injury. Multivariate logistic regression showed that cystatin C (OR=1.906, 95%  CI:1.219～2.980,  P=0.005), increased creatinine clearance rate (OR=2.067, 95% CI 1.271～3.360, P=0.003), APACHE Ⅱscore≥12(OR=6.290,95% CI 2.671～14.813, P ＜0.001), and increased serum APRIL (OR=6.848, 
95% CI 2.510～18.681, P＜0.001) were the independent influencing factors for sepsis-induced acute kidney injury.   Conclusion   The increased serum APRIL in patients with sepsis-induced acute kidney injury is an important risk factor for these patients. Higher serum APRIL is closely related to the occurrence of acute kidney injury in sepsis patients.

Key words: Proliferation-inducing ligand, Sepsis, Acute kidney injury