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Pan YH, Tsai HW, Lin HA, Chen CY, Chao CC, Lin SF, Hou SK. Early Identification of Sepsis-Induced Acute Kidney Injury by Using Monocyte Distribution Width, Red-Blood-Cell Distribution, and Neutrophil-to-Lymphocyte Ratio. Diagnostics (Basel) 2024; 14:918. [PMID: 38732331 PMCID: PMC11083534 DOI: 10.3390/diagnostics14090918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Sepsis-induced acute kidney injury (AKI) is a common complication in patients with severe illness and leads to increased risks of mortality and chronic kidney disease. We investigated the association between monocyte distribution width (MDW), red-blood-cell volume distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), sepsis-related organ-failure assessment (SOFA) score, mean arterial pressure (MAP), and other risk factors and sepsis-induced AKI in patients presenting to the emergency department (ED). This retrospective study, spanning 1 January 2020, to 30 November 2020, was conducted at a university-affiliated teaching hospital. Patients meeting the Sepsis-2 consensus criteria upon presentation to our ED were categorized into sepsis-induced AKI and non-AKI groups. Clinical parameters (i.e., initial SOFA score and MAP) and laboratory markers (i.e., MDW, RDW, and NLR) were measured upon ED admission. A logistic regression model was developed, with sepsis-induced AKI as the dependent variable and laboratory parameters as independent variables. Three multivariable logistic regression models were constructed. In Model 1, MDW, initial SOFA score, and MAP exhibited significant associations with sepsis-induced AKI (area under the curve [AUC]: 0.728, 95% confidence interval [CI]: 0.668-0.789). In Model 2, RDW, initial SOFA score, and MAP were significantly correlated with sepsis-induced AKI (AUC: 0.712, 95% CI: 0.651-0.774). In Model 3, NLR, initial SOFA score, and MAP were significantly correlated with sepsis-induced AKI (AUC: 0.719, 95% CI: 0.658-0.780). Our novel models, integrating MDW, RDW, and NLR with initial SOFA score and MAP, can assist with the identification of sepsis-induced AKI among patients with sepsis presenting to the ED.
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Affiliation(s)
- Yi-Hsiang Pan
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; (Y.-H.P.); (H.-W.T.); (H.-A.L.); (C.-C.C.)
| | - Hung-Wei Tsai
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; (Y.-H.P.); (H.-W.T.); (H.-A.L.); (C.-C.C.)
| | - Hui-An Lin
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; (Y.-H.P.); (H.-W.T.); (H.-A.L.); (C.-C.C.)
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
- Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Ching-Yi Chen
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chun-Chieh Chao
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; (Y.-H.P.); (H.-W.T.); (H.-A.L.); (C.-C.C.)
- Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Sheng-Feng Lin
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; (Y.-H.P.); (H.-W.T.); (H.-A.L.); (C.-C.C.)
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Center of Evidence-Based Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Sen-Kuang Hou
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; (Y.-H.P.); (H.-W.T.); (H.-A.L.); (C.-C.C.)
- Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
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Li D, Yang A, Xia M, Ma K, Zhang J, Guo Y, Zang W. Association between red blood cell distribution width-to-albumin ratio and the prognosis in patients with autoimmune encephalitis: a retrospective cohort study. Front Neurol 2024; 14:1276026. [PMID: 38274889 PMCID: PMC10808499 DOI: 10.3389/fneur.2023.1276026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Aim Red blood cell distribution width-to-albumin ratio (RAR) is a combined new indicator reflecting immunology and has been reported to predict the prognosis of inflammation-related diseases and brain diseases. However, the association and predictive value of RAR in the prognosis of patients with autoimmune encephalitis (AE) has not been reported. Methods This was a retrospective cohort study, and data were collected from the Henan Provincial People's Hospital. RAR was categorized according to quartile. The prognosis was assessed using the modified Rankin Scale (mRS), and an mRS score of ≥3 was defined as a poor prognosis. The logistical regression model was used to explore the association between RAR and the prognosis, with results reported as odds ratio (OR) and 95% confidence interval (CI). The predictive value of RAR was evaluated by calculating the area under the receiving operating curve (AUC), sensitivity, specificity, and accuracy. Results A total of 175 eligible patients were included for analysis, and 51 patients were identified as having poor prognosis. After adjusting age, cancer, other diseases, histological subtype, antiepileptic therapy, anti-tumor treatment, ICU treatment, and length of stay, RAR in the highest quartile (Q4) was found to be significantly associated with the high odds of poor prognosis (OR = 5.63, 95%CI: 1.98-16.02) compared to RAR in the lowest quartile (Q1). In addition, RAR was identified as a predictor for the prognosis of AE patients (AUC = 0.660, 95%CI: 0.574-0.746). Conclusion This study found the close association and predictive value of RAR for the prognosis of AE patients, indicating that RAR might help clinicians identify high-risk populations.
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Affiliation(s)
- Dan Li
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Ali Yang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Mingrong Xia
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Kai Ma
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Jiewen Zhang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Yang Guo
- Department of Neurosurgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
| | - Weizhou Zang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China
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Park JH, Cho SS, Jung J, Choi SS. Feasibility of using red cell distribution width for prediction of postoperative mortality in severe burn patients: an association with acute kidney injury after surgery. Anesth Pain Med (Seoul) 2023; 18:357-366. [PMID: 37919920 PMCID: PMC10635847 DOI: 10.17085/apm.23046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Severe burns cause pathophysiological processes that result in mortality. A laboratory biomarker, red cell distribution width (RDW), is known as a predictor of mortality in critically-ill patients. We examined the association between RDW and postoperative mortality in severe burn patients. METHODS We retrospectively analyzed medical data of 731 severely burned patients who underwent surgery under general anesthesia. We evaluated whether preoperative RDW value can predict 3-month mortality after burn surgery using receiver operating characteristic (ROC) curve analysis, logistic regression, and Cox proportional-hazards regression analysis. Mortality was also analyzed according to preoperative RDW values and incidence of postoperative acute kidney injury (AKI). RESULTS The 3-month mortality rate after burn surgery was 27.1% (198/731). The area under the ROC curve of preoperative RDW to predict mortality after burn surgery was 0.701 (95% confidence interval [CI], 0.667-0.734; P < 0.001) with a cut-off point of 12.9. The adjusted hazard ratio in patients with RDW > 12.9 was 1.238 (95% CI, 1.138-1.347; P < 0.001). Subgroup analysis showed that the survival rate was 88.8% for the non-AKI group with RDW ≤ 12.9 and 17.6% for the AKI group with RDW > 12.9. Preoperative RDW was considered an independent risk factor for mortality (odds ratio, 1.679; 95% CI, 1.378- 2.046; P < 0.001). CONCLUSIONS Preoperative RDW may predict 3-month postoperative mortality in patients with severe burns, while preoperative RDW > 12.9 and postoperative AKI may further increase mortality after burn surgery.
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Affiliation(s)
- Ji Hyun Park
- Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea
| | - Seong-Sik Cho
- Department of Occupational and Environmental Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Jongeun Jung
- Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea
| | - Seong-Soo Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yan YT, Liu HM, Kong YF, Liu JM, Li C, Zhao BC, Liu KX. Association of preoperative neutrophil-lymphocyte ratio with acute kidney injury in patients with non-cardiac surgery: difference among surgical types. Int Urol Nephrol 2023; 55:2647-2656. [PMID: 36964822 DOI: 10.1007/s11255-023-03567-4] [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: 09/19/2022] [Accepted: 03/18/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE To examine the relationship between Neutrophil-Lymphocyte Ratio (NLR) and Acute Kidney Injury (AKI) in patients undergoing noncardiac surgery, and subgroup analysis was performed for different types of non-cardiac surgery. METHODS The present retrospective cohort study included 10,159 adult patients who underwent major noncardiac surgery at Nanfang Hospital, Southern Medical University, between 2008 and 2018. Postoperative AKI was defined as an increase in serum creatinine level of at least 0.3 mg/dl within 48 h, or 1.5 times higher than baseline within 7 days postoperatively according to the Kidney Disease Improving Global Outcome. The correlation between preoperative NLR and postoperative AKI was determined by stepwise multivariate logistic regression analysis, and the predictive value of NLR was evaluated by the receiver operating characteristics curve (ROC) analysis. RESULTS Four hundred and eighty-five (4.77%) patients developed AKI postoperatively. Preoperative NLR was independently associated with postoperative AKI in all patients undergoing non-cardiac surgery (Odds ratio [OR], 1.03; 95% confidence interval [CI], 1.00-1.06). The optimal cut-off value of NLR was 2.12 according ROC analysis. The OR and 95% CI of AKI for NLR > 2.12 was 1.48 (1.21-1.81) compared with NLR ≤ 2.12. In addition, the positive association was mainly shown in patients undergone digestive system surgery with a cut-off value of 2.12 but not in neurological and musculoskeletal system surgeries. CONCLUSION The present study confirmed the association of preoperative NLR with postoperative AKI in digestive system surgical patients. A NLR value of 2.12 may be a useful cut-off to evaluate the risk of AKI.
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Affiliation(s)
- Yang-Tian Yan
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hua-Min Liu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi-Fan Kong
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jia-Ming Liu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Cai Li
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Bing-Cheng Zhao
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Ke-Xuan Liu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Ko HL, Jung J, Lee J, Lim JH, Im DW, Kim YC, Paek JH, Park WY, Kim KM, Lee S, Lee SW, Shin SJ, Kim DK, Han SS, Baek CH, Kim H, Park JY, Ban TH, Kim K. Dynamic nature and prognostic value of the neutrophil-to-lymphocyte ratio in critically ill patients with acute kidney injury on continuous renal replacement therapy: A multicenter cohort study. Front Med (Lausanne) 2023; 10:1162381. [PMID: 37056733 PMCID: PMC10086237 DOI: 10.3389/fmed.2023.1162381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
IntroductionPatients with acute kidney injury (AKI) receiving renal replacement therapy constitute the subgroup of AKI with the highest risk of mortality. Despite recent promising findings on the neutrophil-to-lymphocyte ratio (NLR) in AKI, studies have not yet addressed the clinical implication of the NLR in this population. Therefore, we aimed to examine the prognostic value of NLR in critically ill patients requiring continuous renal replacement therapy (CRRT), especially focusing on temporal changes in NLR.MethodsWe enrolled 1,494 patients with AKI who received CRRT in five university hospitals in Korea between 2006 and 2021. NLR fold changes were calculated as the NLR on each day divided by the NLR value on the first day. We performed a multivariable Cox proportional hazard analysis to assess the association between the NLR fold change and 30-day mortality.ResultsThe NLR on day 1 did not differ between survivors and non-survivors; however, the NLR fold change on day 5 was significantly different. The highest quartile of NLR fold change during the first 5 days after CRRT initiation showed a significantly increased risk of death (hazard ratio [HR], 1.65; 95% confidence intervals (CI), 1.27–2.15) compared to the lowest quartile. NLR fold change as a continuous variable was an independent predictor of 30-day mortality (HR, 1.14; 95% CI, 1.05–1.23).ConclusionIn this study, we demonstrated an independent association between changes in NLR and mortality during the initial phase of CRRT in AKI patients receiving CRRT. Our findings provide evidence for the predictive role of changes in the NLR in this high-risk subgroup of AKI.
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Affiliation(s)
- Hyun Lee Ko
- Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University, Gyeonggi-Do, Republic of Korea
| | - Jiyun Jung
- Clinical Trial Center, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
- Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju, Republic of Korea
| | - Jangwook Lee
- Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju, Republic of Korea
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Jeong-Hoon Lim
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Dha Woon Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Hyuk Paek
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Woo Yeong Park
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Kyeong Min Kim
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
| | - Soyoung Lee
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
| | - Sung Woo Lee
- Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University, Gyeonggi-Do, Republic of Korea
| | - Sung Joon Shin
- Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju, Republic of Korea
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chung Hee Baek
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hyosang Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jae Yoon Park
- Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju, Republic of Korea
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Republic of Korea
| | - Tae Hyun Ban
- Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- *Correspondence: Tae Hyun Ban,
| | - Kipyo Kim
- Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
- Kipyo Kim,
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Gao C, Peng L. Association and prediction of red blood cell distribution width to albumin ratio in all-cause mortality of acute kidney injury in critically ill patients. Front Med (Lausanne) 2023; 10:1047933. [PMID: 36968820 PMCID: PMC10034203 DOI: 10.3389/fmed.2023.1047933] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
AimThe progression of acute kidney injury (AKI) might be associated with systemic inflammation. Our study aims to explore the association and predictive value of the red blood cell distribution width (RDW) to human serum albumin (ALB) ratio (RDW/ALB ratio), an inflammation-related indicator, in the risk of all-cause mortality and renal replacement therapy (RRT) in AKI patients admitted in intensive care units (ICU).MethodsA retrospective cohort study was designed, and data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III). The primary outcome was the risk of all-cause mortality (1-month, 3-month, and 12-month), and the secondary outcome was the risk of RRT. The association between the RDW/ALB ratio and the risk of all-cause mortality and RRT was assessed using the Cox regression analysis, with results shown as hazard ratio (HR) and 95% confidence intervals (CIs). The relationship between the RDW/ALB ratio and crude probability of all-cause mortality or RRT was assessed using restricted cubic splines (RCS). The concordance index (C-index) was used to assess the discrimination of the prediction model.ResultsA total of 13,856 patients were included in our study. In the fully adjusted Cox regression model, we found that a high RDW/ALB ratio was associated with an increased risk of 1-month, 3-month, and 12-month all-cause mortality and RRT (all p < 0.05). Moreover, RCS curves showed the linear relationship between the RDW/ALB ratio and the probability of all-cause mortality and RRT, and the probability was elevated with the increase of the ratio. In addition, the RDW/ALB ratio showed a good predictive performance in the risk of 1-month all-cause mortality, 3-month all-cause mortality, 12-month all-cause mortality, and RRT, with a C-index of 0.728 (95%CI: 0.719–0.737), 0.728 (95%CI: 0.721–0.735), 0.719 (95%CI: 0.713–0.725), and 0.883 (95%CI: 0.876–0.890), respectively.ConclusionThe RDW/ALB ratio performed well to predict the risk of all-cause mortality and RRT in critically ill patients with AKI, indicating that this combined inflammatory indicator might be effective in clinical practice.
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Jia L, Li C, Bi X, Wei F, Meng J, Sun G, Yu H, Dong H, Li B, Cao Y, Wang L, Jiang A. Prognostic Value of Systemic Immune-Inflammation Index among Critically Ill Patients with Acute Kidney Injury: A Retrospective Cohort Study. J Clin Med 2022; 11:jcm11143978. [PMID: 35887742 PMCID: PMC9319546 DOI: 10.3390/jcm11143978] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 02/05/2023] Open
Abstract
Inflammation plays a significant role in the occurrence and development of acute kidney injury (AKI). Evidence regarding the prognostic effect of the systemic immune-inflammation index (SII) in critically ill patients with AKI is scarce. The aim of this study was to assess the association between SII and all-cause mortality in these patients. Detailed clinical data were extracted from the Medical Information Mart for Intensive Care Database (MIMIC)-IV. The primary outcome was set as the in-hospital mortality. A total of 10,764 AKI patients were enrolled in this study. The restricted cubic splines analyses showed a J-shaped curve between SII and the risk of in-hospital and ICU mortality. After adjusting for relevant confounders, multivariate Cox regression analysis showed that both lower and higher SII levels were associated with an elevated risk of in-hospital all-cause mortality. A similar trend was observed for ICU mortality. In summary, we found that the SII was associated in a J-shaped pattern with all-cause mortality among critically ill patients with AKI. SII appears to be have potential applications in the clinical setting as a novel and easily accessible biomarker for predicting the prognosis of AKI patients.
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Affiliation(s)
- Lan Jia
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Chen Li
- Department of Orthopaedics, Tianjin Hospital, Tianjin 300211, China;
| | - Xueqing Bi
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Fang Wei
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Jia Meng
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Guijiang Sun
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Haibo Yu
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Hongye Dong
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Bo Li
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Yueqi Cao
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
| | - Lihua Wang
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
- Correspondence: (L.W.); (A.J.); Tel.: +86-022-8832-6796 (L.W.); +86-022-8832-6563 (A.J.)
| | - Aili Jiang
- Department of Kidney Disease and Blood Purification, Institute of Urology & Key Laboratory of Tianjin, The Second Hospital of Tianjin Medical University, Tianjin 300211, China; (L.J.); (X.B.); (F.W.); (J.M.); (G.S.); (H.Y.); (H.D.); (B.L.); (Y.C.)
- Correspondence: (L.W.); (A.J.); Tel.: +86-022-8832-6796 (L.W.); +86-022-8832-6563 (A.J.)
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Value of neutrophil/lymphocyte ratio, N-terminal pro-B-type natriuretic peptide, urea, and creatinine for the prediction of acute kidney injury in acute heart failure: a retrospective observational study. JOURNAL OF BIO-X RESEARCH 2021. [DOI: 10.1097/jbr.0000000000000115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Li L, Zou G, Liu J. Preoperative Glucose-to-Lymphocyte Ratio is an Independent Predictor for Acute Kidney Injury After Cardiac Surgery in Patients in Intensive Care Unit. Int J Gen Med 2021; 14:6529-6537. [PMID: 34675620 PMCID: PMC8518472 DOI: 10.2147/ijgm.s335896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
Background We aimed to investigate the association between preoperative glucose-to-lymphocyte ratio (GLR) and cardiac surgery associated with acute kidney injury (CSA-AKI) in patients in the intensive care unit (ICU). Methods The Medical Information Mart for Intensive Care IV (MIMIC-IV version 1.0) database was used to identify adults' patients who performed cardiac surgery during ICU stay. The primary outcome was the development of AKI based on the KDIGO criteria. Multivariable logistic regression was applied to investigate the association between GLR and clinical outcomes, and propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were also used to validate our findings. Results The optimal cut-off value for GLR was 1.28. Among the 7181 patients who conducted cardiac surgery, 2072 high-GLR group (≥1.28) patients and 2072 low-GLR group (<1.28) patients, had similar propensity scores were included in this study. After matching, the high-GLR group had a significantly higher incidence of AKI (odds ratio, OR, 3.28, 95% confidence index, 95% CI, 2.81-3.84, P <0.001) even after adjustment for confounding factors. Moreover, the performance of GLR was superior to that of SOFA scores and GLR plus clinical model could add more net benefit for CSA-AKI than clinical model alone. Conclusion Preoperative GLR could serve as a good predictor for CSA-AKI in patients in ICU.
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Affiliation(s)
- Lu Li
- Department of Nephrology, The First People's Hospital of Jiangxia District, Wuhan, 430299, People's Republic of China
| | - Gaorui Zou
- Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, 430022, People's Republic of China
| | - Jie Liu
- Department of Nephrology, The First People's Hospital of Jiangxia District, Wuhan, 430299, People's Republic of China
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10
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Zhu J, Dong Z. Reply to "The Neutrophil-to-Lymphocyte Ratio: An Ideal Marker for Early Diagnosis and Short-Term Prognosis of Acute Kidney Injury?". KIDNEY DISEASES (BASEL, SWITZERLAND) 2021; 7:244-245. [PMID: 34179120 PMCID: PMC8216024 DOI: 10.1159/000512860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/07/2020] [Indexed: 06/13/2023]
Affiliation(s)
- Jiefu Zhu
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, China
| | - Zheng Dong
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, China
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University and Charlie Norwood VA Medical Center, Augusta, Georgia, USA
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11
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Lang SM, Schiffl H. The Neutrophil to Lymphocyte Ratio: An Ideal Marker for Early Diagnosis and Short-Term Prognosis of Acute Kidney Injury? KIDNEY DISEASES (BASEL, SWITZERLAND) 2021; 7:241-243. [PMID: 34179119 DOI: 10.1159/000512861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/07/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Susanne M Lang
- Klinik für Innere Medizin II, University Hospital FSU Jena, Jena, Germany
| | - Helmut Schiffl
- Department of Internal Medicine IV, University Hospital, Munich, Germany
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