Lipopolysaccharide Binding Protein and Soluble Mannose Receptor as Biomarkers for Acute Kidney Injury in Cirrhosis

BACKGROUND: Predicting renal outcomes in acute kidney injury (AKI) and cirrhosis patients remains challenging. This study aimed to identify AKI-associated biomarkers in cirrhotic patients. METHODS: This retrospective cross-sectional study included 709 patients with liver cirrhosis, including 91 with AKI and 91 controls. Lipopolysaccharide binding protein (LBP), soluble CD163 (sCD163), and soluble mannose receptor (sMR) plasma levels were analyzed for association with AKI development and prognosis. Risk factors were identified for AKI onset, AKI-associated 90-day mortality, and poor treatment response. RESULTS: Significantly higher LBP, sCD163, and sMR levels were observed in the AKI group versus controls. LBP of ≥ 2550 ng/mL predicted increased risk of AKI in cirrhotic patients. Among patients with AKI, sMR of ≥ 1595 ng/mL predicted 90-day mortality; these patients had significantly reduced cumulative survival versus those with low sMR. Cumulative survival was significantly low among cirrhotic patients with high sMR levels; sMR of ≥ 1460 ng/mL predicted poor treatment response. Significantly more patients with low sMR had Child-Pugh grade A liver cirrhosis and treatment responders versus the high sMR group. CONCLUSION: LBP, a bacterial translocation marker, is an early indicator of AKI in cirrhotic patients, and sMR reflects immune activation and is associated with short-term mortality and treatment responsiveness.