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Milosevic T, Naumovic R, Sopic M, Vekic J, Guzonjic A, Pesic S, Miljkovic-Trailovic M, Kotur-Stevuljevic J. COVID-19 increases mortality in hemodialysis patients: exploring links with inflammation and telomere attrition. Mol Biol Rep 2024; 51:938. [PMID: 39190187 DOI: 10.1007/s11033-024-09879-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 08/21/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND AND OBJECTIVE An increased risk of mortality and hospitalization was consistently demonstrated in hemodialysis (HD) patients affected by pandemic coronavirus infection (COVID-19). In this study, we analyzed parameters that may impact mortality in COVID-19 HD patients, including neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), C-reactive protein (CRP), COVID-19 disease status and telomere length in peripheral blood cells (TL). MATERIALS AND METHODS A total of 130 chronic hemodialysis patients were enrolled and followed up for 18 months. Patients were categorized into groups based on their COVID-19 disease history and subsequent data about their survival status at the end of the study. Routine laboratory parameters were assessed using standard automated methods and TL was determined using the modified Cawthon method. Survival predictors were analyzed using Kaplan-Meier analysis. RESULTS Deceased patients (30%) were older with higher body mass index (BMI), higher levels of LDH, NLR index, CRP and lower TL and lymphocytes count compared to survivors. Kaplan-Meier survival analysis showed six parameters were significant mortality predictors in the following order of significance: COVID-19 history, 2-years cardiovascular mortality risk score, NLR, TL, CRP, LDH. Using binary logistic regression analysis Summary risk score, a combination of these six parameters revealed as the best predictor of patient's survival in this group of parameters (log rank 25.4, p < 0.001). CONCLUSION Compared to the general population, the mortality rate among HD patients persists at a higher level despite advancements in HD technology and patient care. The situation has been exacerbated by COVID-19, by significant increase in mortality rate among these patients.
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Grants
- 451-03-47/2023 01/ 200161 Ministry of Education, Science, and Technological Development, Republic of Serbia, through Grant Agreement with the University of Belgrade-Faculty of Pharmacy
- 451-03-47/2023 01/ 200161 Ministry of Education, Science, and Technological Development, Republic of Serbia, through Grant Agreement with the University of Belgrade-Faculty of Pharmacy
- 451-03-47/2023 01/ 200161 Ministry of Education, Science, and Technological Development, Republic of Serbia, through Grant Agreement with the University of Belgrade-Faculty of Pharmacy
- 451-03-47/2023 01/ 200161 Ministry of Education, Science, and Technological Development, Republic of Serbia, through Grant Agreement with the University of Belgrade-Faculty of Pharmacy
- 451-03-47/2023 01/ 200161 Ministry of Education, Science, and Technological Development, Republic of Serbia, through Grant Agreement with the University of Belgrade-Faculty of Pharmacy
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Affiliation(s)
- Tamara Milosevic
- Laboratory Diagnostics Service, Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia.
- Department of Hematology and Cytological Diagnostics of Fluids Laboratory Diagnostics Service Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia.
| | - Radomir Naumovic
- Clinical Department of Nephrology and Metabolic Disorders with Dialysis "Prof. Dr. Vasilije Jovanovic", Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia
- Faculty of Medicine, University of Belgrade, dr Subotica 8, Belgrade, 11000, Serbia
| | - Miron Sopic
- Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
| | - Jelena Vekic
- Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
| | - Azra Guzonjic
- Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
| | - Snezana Pesic
- Clinical Department of Nephrology and Metabolic Disorders with Dialysis "Prof. Dr. Vasilije Jovanovic", Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia
| | - Milica Miljkovic-Trailovic
- Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
| | - Jelena Kotur-Stevuljevic
- Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
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Tang L, Yang Q, Ma R, Zhou P, Peng C, Xie C, Liang Q, Wu T, Gao W, Yu H, Deng G, Dai Z, Mao N, Xiao X. Association between lactate dehydrogenase and the risk of diabetic kidney disease in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2024; 15:1369968. [PMID: 38567310 PMCID: PMC10985160 DOI: 10.3389/fendo.2024.1369968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This study aims to investigate the association between lactate dehydrogenase (LDH) and the risk of diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D). Methods The study enrolled patients with diagnosis of T2D between 2009 and 2018 from the National Nutrition and Health Examination Survey (NHANES) database. Demographic information, laboratory test, and diagnostic data were collected. Restricted cubic spline (RCS) plots were used to assess the dose-effect relationship between LDH levels and the risk of DKD in patients with T2D. Based on LDH levels, individuals were divided into higher and lower groups using dichotomy, and multivariate logistic regression analysis was conducted to explore the relationship between different LDH levels and the risk of DKD in T2D patients. Stratified analysis was performed to assess the consistency of the result. Results A total of 4888 patients were included in the study, with 2976 (60.9%) patients without DKD and 1912 (39.1%) patients with DKD. RCS plots showed that the risk of DKD increased with increasing LDH levels. Multifactorial logistic regression analysis revealed that T2D patients with higher LDH levels had a 45% increased risk of DKD compared to those with lower LDH levels (OR=1.45; 95% CI: 1.11-1.89). Furthermore, each standard deviation increase in LDH level was associated with a 24% increase in DKD incidence among T2D patients (OR=1.24; 95% CI: 1.07-1.44). Stratified analysis consistently supported these findings. Conclusions LDH can serve as a valuable biomarker for screening DKD in patients with T2D.
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Affiliation(s)
- Linqiao Tang
- Research Core Facility of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianyu Yang
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Rong Ma
- Department of Nephrology, People’s Hospital of Xindu District, Chengdu, China
| | - Ping Zhou
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Cong Peng
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Chunpeng Xie
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Qiyuan Liang
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Tingyu Wu
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Wuyu Gao
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Haiyan Yu
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Guifei Deng
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Zhen Dai
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Nan Mao
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Xiang Xiao
- Research Core Facility of West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
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Yu J, Zhu L, Ni J, Tong M, Wang H. Technique failure in peritoneal dialysis-related peritonitis: risk factors and patient survival. Ren Fail 2023; 45:2205536. [PMID: 37125594 PMCID: PMC10134955 DOI: 10.1080/0886022x.2023.2205536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the association between patient clinical characteristics and technique failure in peritoneal dialysis-related peritonitis (PDRP). The effect of peritonitis-associated technique failure on patient survival was also assessed. METHODS Patients diagnosed with PDRP from January 1, 2010 to June 30, 2022 were retrospectively reviewed and analyzed. Relevant demographic, biochemical, and clinical data were collected. Univariate and multivariate logistic regression analyses were used to determine the predictors of peritonitis-associated technique failure in PD. Patients were divided into technique failure (F group) and nontechnique failure (NF group) groups. Patients were followed until death or until the date of Oct 1, 2022. Kaplan-Meier survival curves and landmark analysis were used to assess the survival of the PDRP cohort. Cox regression models were used to assess the association between potential risk factors and mortality. RESULTS A total of 376 patients with 648 cases of PDRP were included in this study. Multivariate logistic regression analysis demonstrated that peritoneal dialysis (PD) duration (OR = 1.12 [1.03, 1.21], p = 0.005), dialysate WBC count on Day 3 after antibiotic therapy (OR = 1.41 [1.22, 1.64], p = 0.001), blood neutrophil-to-lymphocyte ratio (NLR) (OR = 1.83 [1.25, 2.70], p = 0.002), and serum lactate dehydrogenase (LDH) (OR = 4.13 [1.69, 10.11], p = 0.002) were independent predictors for technique failure in PDRP. Furthermore, serum high-density lipoprotein (HDL) (OR = 0.28 [0.13, 0.64], p = 0.002) was a protective factor against technique failure. According to the Kaplan-Meier analysis, patients experiencing peritonitis-associated technique failure had lower postperitonitis survival (log-rank = 4.326, p = 0.038). According to the landmark analysis, patients with a history of peritonitis-associated technical failures had a higher 8-year mortality after peritoneal dialysis. A Cox model adjusted for plausible predetermined confounders showed that technique failure was independently associated with all-cause mortality. CONCLUSIONS Dialysate WBC count on Day 3, PD duration, NLR, and LDH were independent risk factors for technique failure, whereas HDL was a protective factor. Peritonitis-associated technique failure had a higher risk of mortality and adverse effects on postperitonitis survival.
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Affiliation(s)
- Jin Yu
- Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University), Hangzhou, P. R. China
| | - Lingli Zhu
- Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University), Hangzhou, P. R. China
| | - Jun Ni
- Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University), Hangzhou, P. R. China
| | - Mengli Tong
- Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University), Hangzhou, P. R. China
| | - Hua Wang
- Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University), Hangzhou, P. R. China
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Rojas-Sahagún VM, Núñez-Martínez FJ, Verazaluce-Rodríguez BE, Luna-Montalbán R. [LDH-neutrophil-lymphocyte index as a predictor of 28-day mortality in patients with COVID-19]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:567-573. [PMID: 37757443 PMCID: PMC10599788 DOI: 10.5281/zenodo.8316422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/23/2023] [Indexed: 09/29/2023]
Abstract
Background Coronavirus disease 2019 (COVID-19) represents the greatest health crisis of our times; it was declared by WHO a pandemic in March 2020. The risk of presenting a severe disease is inter-individual, since it varies according to age, comorbidities, and immunological status, in addition to the type of SARS-CoV-2 variant. The neutrophil/lymphocyte ratio (NLR) and lactic dehydrogenase (LDH) are widely used markers to assess the severity and predict the course of the disease in patients with COVID-19, with a direct relationship of higher value-worse prognosis. Objective To verify if the LDH-neutrophil-lymphocyte index calculated from laboratory tests taken within the first 24 hours of admission is useful as a predictor of 28-day mortality in adult patients diagnosed with COVID-19. Material and methods Retrospective and analytical cohort study. All consecutive patients over 16 years of any gender, admitted to a tertiary care center from March 2020 to March 2021, who had a diagnosis of COVID-19 with a positive PCR for SARS-CoV-2, were included. Results Higher levels of the LDHNL index were associated with higher mortality in patients hospitalized for COVID-19 (Q2 vs. Q1: RR 1.52 [1.24-1.87], p < 0.05; Q3 vs. Q1: RR 1.87 [1.55-2.25], p < 0.05; and Q4 vs. Q1: RR 2.74 [2.22-3-39], p < 0.05). Conclusions The serum LDHNL index taken in the first 24 hours of admission can help to predict early the risk of mortality in hospitalized patients with COVID-19.
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Affiliation(s)
- Víctor Manuel Rojas-Sahagún
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Medicina Interna. León, Guanajuato, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Francisco Javier Núñez-Martínez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Medicina Interna. León, Guanajuato, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Blanca Elena Verazaluce-Rodríguez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Dermatología. León, Guanajuato, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Rafael Luna-Montalbán
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Infectología. León, Guanajuato, MéxicoInstituto Mexicano del Seguro SocialMéxico
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Xiao X, Zhang J, Lang Y, Cai L, Yang Q, Liu K, Ji S, Ju X, Liu F. Associations of lactate dehydrogenase with risk of renal outcomes and cardiovascular mortality in individuals with diabetic kidney disease. Diabetes Res Clin Pract 2023; 203:110838. [PMID: 37478980 DOI: 10.1016/j.diabres.2023.110838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE This study aimed to investigate the role of the lactate dehydrogenase (LDH) in the development of end-stage renal disease (ESRD) and the cardiovascular mortality in individuals with diabetic kidney disease (DKD). METHODS Two cohorts were recruited in this study. We explored the correlation between LDH and renal injury in individuals with DKD in using a Cohort 1. Additionally, we validated this correlation in the NHANES database and further investigated its association with the risk of cardiovascular mortality in Cohort 2 which also comprised individuals with DKD. RESULTS In cohort 1, multivariate Cox regression analysis demonstrated that individuals in DKD with higher LDH were independently associated with an increased risk of ESRD compared to those with lower LDH (HR = 2.11; 95 % CI, 1.07-4.16). In cohort 2, linear regression models showed that LDH affects the level of albumin-creatinine ratio (ACR) (β = 2.95, P = 0.001). Additionally, multivariate Cox regression analysis results showed that an increase in LDH per 1-standard deviation (SD) was associated with a 27 % increased risk of cardiovascular mortality (HR = 1.27; 95 % CI, 1.09-1.48). CONCLUSIONS LDH levels are associated with renal injury and progression to ESRD, as well as being an independent risk factor for cardiovascular in individuals with DKD.
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Affiliation(s)
- Xiang Xiao
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China; Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, 610500 Chengdu, China; Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Junlin Zhang
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China
| | - Yanling Lang
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China; Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Linli Cai
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China; Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Qing Yang
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China; Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Kai Liu
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China; Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Shuming Ji
- Department of Project Design and Statistics, West China Hospital, Sichuan University, Chengdu, China
| | - Xuegui Ju
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China; Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, 610500 Chengdu, China; Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Fang Liu
- Division of Nephrology, West China Hospital of Sichuan University, 610041, Chengdu, China; Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China.
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Deng Y, Li X, Lai Q, Wang F, Zhang C, Yang Y, Jiang D, Kang H, Wang H, Liao D. Prognostic implication of lactic dehydrogenase-to-albumin ratio in critically ill patients with acute kidney injury. Clin Exp Nephrol 2023; 27:349-357. [PMID: 36719499 PMCID: PMC9887249 DOI: 10.1007/s10157-023-02321-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/17/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND No studies have been published on the correlation between lactic dehydrogenase-to-albumin ratio (LAR) and poor prognosis of acute kidney injury (AKI) patients, warranting further research. This analysis sought to investigate the prognostic implication of LAR in critically ill patients with AKI. METHODS The present study enrolled 11,046 and 5180 adults with AKI from the Medical Information Mart for Intensive Care III (MIMIC III) and MIMIC IV, respectively. Data from MIMIC IV were identified as the training cohort, and those from MIMIC III were identified as the validation cohort. We applied multivariate regression analysis to identify the link between LAR and all-cause mortality. Restricted cubic spline (RCS) was conducted to figure out the correlation between LAR and in-hospital mortality. Furthermore, we carried out stratification analyses to examine if the effects of LAR on in-hospital mortality were consistent across various subclasses. RESULTS The level of LAR was remarkably higher in the in-hospital non-survivor group (p < 0.001). Furthermore, the increased LAR group presented a remarkably higher rate of in-hospital mortality at AKI stages 1, 2, and 3 compared with the decreased LAR group (all p < 0.001). Multivariate regression analyses exhibited the independent prognostic significance of LAR for all-cause mortality (all p < 0.001). MIMIC III observed concordant results. RCS indicated a non-linear correlation between LAR and in-hospital death (P for non-linearity < 0.001). The relationship between LAR and in-hospital mortality was still significant in patients with various subclasses. CONCLUSIONS Elevated LAR at admission is a prognostic risk factor for critically ill patients with AKI.
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Affiliation(s)
- Yonghua Deng
- Department of Nephrology, Chengdu Second People's Hospital, Chengdu, China
| | - Xinchun Li
- North Sichuan Medical College, Nanchong, China
- Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Qiancheng Lai
- Geriatric Diseases Institute of Chengdu, Department of Cardiothoracic Surgery, Chengdu Fifth People's Hospital, Chengdu, China
| | - Fengping Wang
- Department of Nephrology, Chengdu Second People's Hospital, Chengdu, China
| | - Chenglong Zhang
- Department of Nephrology, Chengdu Second People's Hospital, Chengdu, China
| | - Yingjia Yang
- Department of Nephrology, Chengdu Second People's Hospital, Chengdu, China
| | - Dan Jiang
- Department of Nephrology, Chengdu Second People's Hospital, Chengdu, China
| | - Han Kang
- Department of Nephrology, Chengdu Second People's Hospital, Chengdu, China
| | - Huan Wang
- Department of Nephrology, Chengdu Second People's Hospital, Chengdu, China
| | - Dan Liao
- Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
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Lin L, Gao R, Chen L, Wu Z, Wei X, Xie Y. Relationship between serum lactate dehydrogenase and mortality after cardiac arrest: A retrospective cohort study. Medicine (Baltimore) 2022; 101:e31499. [PMID: 36397356 PMCID: PMC9666175 DOI: 10.1097/md.0000000000031499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Serum lactate dehydrogenase (LDH) has been identified as an independent risk factor for predicting all-cause mortality in patients with multiple diseases. However, the prognostic value of LDH levels in post-cardiac arrest patients remains uncertain. This study aimed to assess the association between LDH and mortality in intensive care unit (ICU) patients after cardiac arrest. This retrospective observational study is based on data from the Dryad Digital Repository, which included 374 consecutive adult patients after cardiac arrest. Patients were divided into 2 groups based on median LDH values. A multivariate Cox proportional hazards model was established to assess the independent relationship between LDH and ICU mortality. Cumulative mortality was compared using Kaplan-Meier curves. The cohort included 374 patients, of which 51.9% (194/374) died in the ICU. The overall death rate from cardiac arrest was significantly higher for patients with LDH ≥ 335 IU/L (59.6%) than for those with LDH < 335 IU/L (44.1%). In multiple Cox regression models, hazard ratios (HR) and corresponding 95% confidence intervals (CI) for logLDH and the 2 LDH groups were 1.72 (1.07, 2.78) and 1.42 (1.04, 1.93), respectively. Participants with LDH ≥ 335IU/L had a higher incidence of ICU mortality than LDH < 335 IU/L, as shown by the Kaplan-Meier curves (P = .0085). Subgroup analysis revealed that the association between LDH and ICU mortality was vitally stable, with all P interactions from different subgroups >.05. Serum LDH levels are positively associated with ICU mortality in patients after cardiac arrest, especially for patients with LDH ≥ 335 IU/L.
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Affiliation(s)
- Liangen Lin
- Emergency Department, Wenzhou People’s Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China
| | - Renxian Gao
- Emergency Department, Wenzhou People’s Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China
| | - Linglong Chen
- Emergency Department, Wenzhou People’s Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China
| | - Zhang Wu
- Emergency Department, Wenzhou People’s Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China
| | - Xiaowu Wei
- Emergency Department, Wenzhou People’s Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China
| | - Yuequn Xie
- Emergency Department, Wenzhou People’s Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China
- * Correspondence: Yuequn Xie, Emergency Department, Wenzhou People’s Hospital, 57 Canghou Street, Wenzhou, Zhejiang 325000, China (e-mail: )
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Jin XX, Fang MD, Hu LL, Yuan Y, Xu JF, Lu GG, Li T. Elevated lactate dehydrogenase predicts poor prognosis of acute ischemic stroke. PLoS One 2022; 17:e0275651. [PMID: 36206280 PMCID: PMC9544033 DOI: 10.1371/journal.pone.0275651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Lactate dehydrogenase (LDH) is associated with the prognosis of many diseases, but the relationship between LDH and the poor prognosis (recurrence and death) of acute ischemic stroke (AIS) has not been fully clarified. This study aimed to investigate the association between admission LDH level and poor prognosis in patients with AIS. Methods This retrospective study enrolled AIS patients treated in Taizhou Hospital of Zhejiang Province from July 2019 to December 2019. Poor prognosis included AIS recurrence and all-cause death at 3, 6, and 18 months. The correction between LDH and poor prognosis or all-cause death was assessed. Lasso Cox expression and multivariate Cox expression analyses were used to evaluate the association of LDH with the risk of poor prognosis and all-cause death, respectively. A nomogram was constructed to evaluate the predictive Values of LDH for the poor prognosis and all-cause death of AIS. Results 732 patients were included in the study. Multivariate analysis shows that admission LDH levels were significantly correlated with poor prognosis [odds ratio (OR),1.003; 95% confidence interval (95% CI), 1.001–1.005; P = 0.001] and all-cause death (OR, 1.005; 95% CI, 1.000–1.009; P = 0.031). The correlation analysis showed that admission LDH level was positively correlated with National Institutes of Health Stroke Scale (NIHSS) score and modified Rankin Scale (mRS) score. Time-dependent receiver operating characteristic (td-ROC) curves analysis showed that the AUC values of admission LDH level for predicting prognosis of AIS patients in 3-month, 6-month, 12-month and 18-month were 0.706 (95% CI, 0.604–0.810), 0.653 (95% CI, 0.583–0.723), 0.616 (95% CI, 0.556–60676) and 0.610 (95% CI, 0.552–0.680), respectively. And td-ROC also showed that the AUC values of admission LDH level for predicting all-cause death of AIS patients in 3-month, 6-month,12-month and 18-month were 0.861 (95% CI, 0.764–0.958), 0.824 (95% CI, 0.753–0.890), 0.726 (95% CI, 0.633–0.819) and 0.715 (95% CI, 0.622–0.807), respectively. The nomograms were constructed to create the predictive models of the poor prognosis and all-cause death of AIS. Conclusion Higher LDH levels are independently associated with poor prognosis and all-cause death of AIS.
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Affiliation(s)
- Xia-Xia Jin
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province, China
| | - Mei-Dan Fang
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province, China
| | - Ling-Ling Hu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province, China
| | - Yuan Yuan
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province, China
| | - Jiu-Fei Xu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province, China
| | - Guo-Guang Lu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province, China
- * E-mail: (G-GL); (TL)
| | - Tao Li
- Department of Cardiovascular Medicine, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province, China
- * E-mail: (G-GL); (TL)
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Zeng Y, Zhao Y, Dai S, Liu Y, Zhang R, Yan H, Zhao M, Wang Y. Impact of lactate dehydrogenase on prognosis of patients undergoing cardiac surgery. BMC Cardiovasc Disord 2022; 22:404. [PMID: 36088306 PMCID: PMC9463775 DOI: 10.1186/s12872-022-02848-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Lactate dehydrogenase (LDH) has been reported in multiple heart diseases. Herein, we explored the prognostic effects of preoperative LDH on adverse outcomes in cardiac surgery patients. Methods Retrospective data analysis was conducted from two large medical databases: Medical Information Mart for Intensive Care (MIMIC) III and MIMIC IV databases. The primary outcome was in-hospital mortality, whereas the secondary outcomes were 1-year mortality, continuous renal replacement therapy, prolonged ventilation, and prolonged length of intensive care unit and hospital stay. Results Patients with a primary endpoint had significantly higher levels of LDH (p < 0.001). Multivariate regression analysis presented that elevated LDH was independently correlated with increased risk of primary and secondary endpoints (all p < 0.001). Subgroup analyses showed that high LDH was consistently associated with primary endpoint. Moreover, LDH exhibited the highest area under the curve (0.768) for the prediction of primary endpoint compared to the other indicators, including neutrophil–lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet–lymphocyte ratio (PLR), lactate, and simplified acute physiology score (SAPS) II. The above results were further confirmed in the MIMIC IV dataset. Conclusions Elevated preoperative LDH may be a robust predictor of poor prognosis in cardiac surgery patients, and its predictive ability is superior to NLR, LMR, PLR, lactate, and SAPS II. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02848-7.
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