Clinical Research

Effect of lactate dehydrogenase to albumin ratio on the short⁃term prognosis in patients with sepsis⁃associated acute kidney injury

  • Guomin ZHAO ,
  • Hui ZHANG ,
  • Pucong YE ,
  • Wei. CHEN
Expand
  • Department of Critical Care Medicine,Center for Emergency and Critical Care Medical,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China

Received date: 2024-02-11

  Online published: 2024-07-09

Abstract

Objective To explore the relationship between lactate dehydrogenase to albumin ratio (LAR) and short?term prognosis in patients with sepsis?associated acute kidney injury (AKI). Methods A retrospective analysis was conducted on 463 sepsis patients treated in the intensive care unit (ICU) of Beijing Shijitan Hospital, Capital Medical University, from January 2018 to June 2022. The patients were divided into two groups: a group with secondary AKI (AKI group) and the one without acute kidney injury (non?AKI group). Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ), Sequential Organ Failure Assessment (SOFA), and levels of procalcitonin (PCT), C?reactive protein (CRP), serum creatinine (SCr), lactate dehydrogenase (LDH), and albumin (ALB) were compared between the two groups. Multivariate logistic regression analysis was used to determine prognostic factors for sepsis?associated acute kidney injury, and Receiver Operating Characteristic (ROC) analysis was performed to assess the predictive value of APACHE Ⅱ score, SOFA score, PCT, SCr, and lactate dehydrogenase to albumin ratio (LAR) for short?term prognosis of sepsis?associated acute kidney injury. Results The 28?day mortality rate in the non?AKI group was lower than that in the AKI group, and the length of stay in ICU was shorter in the non?AKI group than in the AKI group (P < 0.05). APACHE Ⅱ score, SOFA score, PCT, SCr and LAR were independent influencing factors for 28?days death in patients with sepsis?associated acute kidney injury. The ROC curve analysis showed that LAR level had a higher predictive value for short?term prognosis in patients with sepsis?associated AKI as compared with APACHE Ⅱ score, SOFA score, PCT, and SCr. Conclusions LAR is an independent risk factor for sepsis?associated AKI and is associated with 28?day mortality in patients.

Cite this article

Guomin ZHAO , Hui ZHANG , Pucong YE , Wei. CHEN . Effect of lactate dehydrogenase to albumin ratio on the short⁃term prognosis in patients with sepsis⁃associated acute kidney injury[J]. The Journal of Practical Medicine, 2024 , 40(13) : 1803 -1807 . DOI: 10.3969/j.issn.1006-5725.2024.13.007

References

1 SINGER M, DEUTSCHMAN C S, SEYMOUR C W, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J]. JAMA, 2016,315(8):801-810. doi:10.1001/jama.2016.0287
2 RUDD K E, JOHNSON S C, AGESA K M, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study[J]. Lancet, 2020,395(10219):200-211. doi:10.1016/s0140-6736(19)32989-7
3 PEERAPORNRATANA S, MANRIQUE-CABALLERO C L, GóMEZ H, et al. Acute. kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment[J]. Kidney Int, 2019,96(5):1083-1099. doi:10.1016/j.kint.2019.05.026
4 张磊,江巍,郑玉雯,等. 新型冠状病毒肺炎严重程度危险因素的分析[J]. 实用医学杂志, 2020,36(14):1866-1871.
5 刘蓉,于智彩,尚长雪,等. 不同方法对中国西南地区儿童重症监护病房脓毒症病死率的预测价值[J]. 中华儿科杂志, 2024,62(3): 204-210. doi:10.3760/cma.j.cn112140-20231013-00282
6 CHEBL R BOU, JAMALI S, SABRA M, et al. Lactate/Albumin Ratio as a Predictor of In-Hospital Mortality in Septic Patients Presenting to the Emergency Department[J]. Front Med (Lausanne), 2020, 7:550182. Published 2020 Sep 22. doi:10.3389/fmed.2020.550182
7 DeNG S, GAO J, ZHAO Z, et al. Albumin/Procalcitonin Ratio Is a Sensitive Early Marker of Nosocomial Blood Stream Infection in Patients with Intra-Cerebral Hemorrhage[J]. Surg Infect (Larchmt), 2019, 20(8):643-649. doi:10.1089/sur.2018.260
8 FENG D Y, ZHOU Y Q, ZOU X L, et al. Elevated Blood Urea Nitrogen-to-Serum Albumin Ratio as a Factor That Negatively Affects the Mortality of Patients with Hospital-Acquired Pneumonia[J]. Can J Infect Dis Med Microbiol, 2019, 2019:1547405. doi:10.1155/2019/1547405
9 KHWAJA A. KDIGO clinical practice guidelines for acute kidney injury[J]. Nephron Clin Pract, 2012, 120:179-184. doi:10.1159/000339789
10 TAKEGAWA R, KABATA D, SHIMIZU K, et al. Serum albumin as a risk factor for death in patients with prolonged sepsis: An observational study[J]. J Crit Care, 2019, 51:139-144. doi:10.1016/j.jcrc.2019.02.004
11 LUNA C M, PERíN M M. Can lactate dehydrogenase (LDH) be used as a marker of severity of pneumonia in patients with renal transplant?[J]. Ann Transl Med, 2020, 8(15):911. doi:10.21037/atm-2020-34
12 ZHANG D, SHI L. Serum lactate dehydrogenase level is associated with in-hospital mortality in critically Ill patients with acute kidney injury[J]. Int Urol Nephrol, 2021, 53(11):2341-2348. doi:10.1007/s11255-021-02792-z
13 QIAO J, CUI L. Multi-Omics Techniques Make it Possible to Analyze Sepsis-Associated Acute Kidney Injury Comprehensively[J]. Front Immunol, 2022, 13:905601. doi:10.3389/fimmu.2022.905601
14 PATIL N K, PARAJULI N, MACMILLAN-CROW L A, et al. Inactivation of renal mitochondrial respiratory complexes and manganese superoxide dismutase during sepsis: mitochondria-targeted antioxidant mitigates injury[J]. Am J Physiol Renal Physiol, 2014,306(7): F734-F743. doi:10.1152/ajprenal.00643.2013
15 GOMEZ H, INCE C, DE BACKER D, et al. A unified theory of sepsis-induced acute kidney injury: inflammation, microcirculatory dysfunction, bioenergetics, and the tubular cell adaptation to injury[J]. Shock, 2014,41(1):3-11. doi:10.1097/shk.0000000000000052
16 蒋芬,文南萍,莫红艳,等. 中性粒细胞/淋巴细胞比值在重症患者急性肾损伤的应用价值[J]. 实用医学杂志, 2020,36(21):2958-2961. doi:10.3969/j.issn.1006-5725.2020.21.014
17 WU N, LIU T, TIAN M, et al. Albumin, an interesting and functionally diverse protein, varies from 'native' to 'effective' (Review) [J]. Mol Med Rep, 2023, 29(2): 24. doi:10.3892/mmr.2023.13147
18 LIANG M, REN X, HUANG D, et al. The association between lactate dehydrogenase to serum albumin ratio and the 28-day mortality in patients with sepsis-associated acute kidney injury in intensive care: a retrospective cohort study[J]. Ren Fail, 2023,45(1):2212080. doi:10.1080/0886022x.2023.2212080
19 白瑜,于锐,田密,等. 白蛋白对肾小管上皮细胞转分化的影响及其分子机制[J]. 山东医药, 2020,60(35):22-25. doi:10.3969/j.issn.1002-266X.2020.35.005
20 马娜,金雨舟,刘福菁,等. 乳酸脱氢酶白蛋白比值对重症肺炎患者并发弥散性血管内凝血的预测价值[J]. 中国呼吸与危重监护杂志, 2023,22(12):845-851. doi:10.7507/1671-6205.202308059
21 LUNA C M, PERíN M M. Can lactate dehydrogenase (LDH) be used as a marker of severity of pneumonia in patients with renal transplant? [J]. Ann Transl Med, 2020, 8(15): 911. doi:10.21037/atm-2020-34
22 FENG J F, WANG L, YANG X, et al. Prognostic value of lactate. dehydrogenase to albumin ratio (LAR) in patients with resectable esophageal squamous cell carcinoma[J]. Cancer Manag Res, 2019, 11:7243-7251. doi:10.2147/cmar.s208320
23 JEON S Y, RYU S, OH S K, et al. Lactate dehydrogenase to albumin ratio as a prognostic factor for patients with severe infection requiring intensive care[J]. Medicine (Baltimore), 2021,100(41): e27538. doi:10.1097/md.0000000000027538
Outlines

/