H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis-A Secondary Analysis of the…

Cohort studyCritical care medicine· Aug 2026

H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis-A Secondary Analysis of the SISPCT Randomized Control Trial.

Caroline Neumann, Frank Bloos, Teddy Tun Win Hla … SepNet Critical Care Trials Group

NephrologyCohort studyQ1IF 3.4

Higher admission H3.1 nucleosome levels linked to greater risk of dialysis in sepsis

H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis-A Secondary Analysis of the SISPCT Randomized Control Trial.

Caroline Neumann … SepNet Critical Care Trials Group

Critical care medicine · Aug 2026

Background

The release of neutrophil extracellular traps is a key immune host defense mechanism that can contribute to organ damage during sepsis if excessive.

Purpose

We sought to determine if plasma H3.1 nucleosome levels could serve as predictive biomarkers for both renal replacement therapy (renal replacement therapy) requirements and 28-day mortality.

Methods

From 33 ICUs in Germany recruited between November 6, 2009, and June 6, 2013, including a 90-day follow-up period.

n = 971 patients

Results

each tenfold rise in H3.1 raised 28 day dialysis risk 80%

HR 1.80 (95% CI 1.34 to 2.40)

null 1

1.34

2.40

CI excludes the null - significant

More results

We evaluated associations between H3.1 levels and mortality and the time to commencement of renal replacement therapy using multivariable Cox regression.

A total of 443 patients (45.6%) presented with sepsis, and 520 patients (53.6%) had septic shock.

More results

In a multivariable analysis for 28-day mortality, a one unit increase in log10 H3.1 levels was associated with a 48% increase in 28-day mortality (adjusted hazard ratio [HR], 1.48, 95% CI, 1.07-2.04; p = 0.02).

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Conclusion

Elevated levels of H3.1 nucleosomes at admission are associated with mortality and acute kidney injury requiring renal replacement therapy.

H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis-A Secondary Analysis of the SISPCT Randomized Control Trial.

H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis-A Secondary Analysis of the SISPCT Randomized Control Trial.

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