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Article

Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury

  • Authors:
    • Ruoran Wang
    • Min He
    • Jianguo Xu
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China, Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
  • Article Number: 69
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    Published online on: January 16, 2026
       https://doi.org/10.3892/etm.2026.13064
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Abstract

As an important anticoagulant molecule, antithrombin III (ATIII) has been confirmed to inhibit inflammation and to alleviate renal ischemia‑reperfusion injury. The present study aimed to explore the relationship between serum ATIII level and acute kidney injury (AKI) in patients with traumatic brain injury (TBI). The clinical data of patients diagnosed with TBI and hospitalized in the West China Hospital (Chengdu, China) between January 2015 and June 2019 were collected. Logistic regression analysis was performed to analyze the relationship between ATIII and AKI and to construct predictive models. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the predictive value of ATIII and models were constructed. As a result, 203 patients with TBI were included in the present study. A total of 43 (19.7%) patients developed AKI at 24 h after admission. Compared with the non‑AKI group, the AKI group had a lower Glasgow Coma Scale, injury severity score and ATIII, but had a higher glucose level, prothrombin time, levels of blood urea nitrogen and serum creatinine (SCr) and higher transfusion rate of fresh frozen plasma (FFP), red blood cell and hydroxyethyl starch. The mortality of the AKI group was 65.1%, which was higher compared with the 30.0% of the non‑AKI group. SCr, ATIII and transfusion of FFP were independently associated with development of AKI after TBI. The AUC of the constructed three‑factors predictive model was 0.850, which was higher compared with the AUC of 0.759 of only ATIII. Overall, ATIII was an effective predictive marker of AKI after TBI. Evaluating serum ATIII level and maintaining normal ATIII level may be beneficial for physicians to reduce the occurrence of AKI in patients with TBI.

View Figures

Figure 1

Flowchart diagram of TBI patients
inclusion. TBI, traumatic brain injury.

Figure 2

Risk predictors explored by the least
absolute shrinkage and selection operator (LASSO) binary logistic
regression analysis. (A) The risk predictors selection using the
least absolute shrinkage and selection operator (LASSO) binary
logistic regression analysis. The two dotted vertical lines mark
the optimal values by minimum criteria and 1-s.e. criteria. The
three variables were selected by LASSO binary logistic regression
analysis. (B) LASSO coefficient profiles of the 39 variables.
LASSO, least absolute shrinkage and selection operator.

Figure 3

Receiver operating characteristic
curve of single ATIII and constructed predictive models for
predicting AKI in included TBI patients. The AUC value of ATIII,
serum creatinine, two-factors predictive model and three-factors
predictive model was 0.759 (0.674-0.844), 0.760 (0.684-0.836),
0.831 (0.770-0.891) and 0.850 (0.792-0.909), respectively. ATIII,
antithrombin III; AKI, acute kidney injury; TBI, traumatic brain
injury; AUC, area under the receiver operating characteristic
curve; Scr, serum creatinine; FFP, fresh frozen plasma.
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Wang R, He M and Xu J: <p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>. Exp Ther Med 31: 69, 2026.
APA
Wang, R., He, M., & Xu, J. (2026). <p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>. Experimental and Therapeutic Medicine, 31, 69. https://doi.org/10.3892/etm.2026.13064
MLA
Wang, R., He, M., Xu, J."<p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>". Experimental and Therapeutic Medicine 31.3 (2026): 69.
Chicago
Wang, R., He, M., Xu, J."<p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>". Experimental and Therapeutic Medicine 31, no. 3 (2026): 69. https://doi.org/10.3892/etm.2026.13064
Copy and paste a formatted citation
x
Spandidos Publications style
Wang R, He M and Xu J: <p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>. Exp Ther Med 31: 69, 2026.
APA
Wang, R., He, M., & Xu, J. (2026). <p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>. Experimental and Therapeutic Medicine, 31, 69. https://doi.org/10.3892/etm.2026.13064
MLA
Wang, R., He, M., Xu, J."<p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>". Experimental and Therapeutic Medicine 31.3 (2026): 69.
Chicago
Wang, R., He, M., Xu, J."<p>Serum antithrombin III level predicts acute kidney injury in patients with traumatic brain injury</p>". Experimental and Therapeutic Medicine 31, no. 3 (2026): 69. https://doi.org/10.3892/etm.2026.13064
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