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Association between lactate dehydrogenase to albumin ratio and acute kidney injury in patients with sepsis: a retrospective cohort study

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Abstract

Background

Serum lactate dehydrogenase to albumin ratio (LAR) is associated with poor outcomes in malignancy and pneumonia. However, there are few studies suggesting that LAR is associated with the occurrence of acute kidney injury (AKI) in patients with sepsis, which was investigated in this study.

Methods

We conducted a retrospective cohort study based on the Medical Information Mart for Intensive Care (MIMIC)-IV database. The primary outcome was the occurrence of AKI within 2 days and 7 days. Multivariable logistic regression models were used to calculate odds ratios to validate the association between LAR and AKI, in-hospital mortality, RRT use, and recovery of renal function, respectively.

Results

A total of 4010 participants were included in this study. The median age of the participants was 63.5 years and the median LAR was 10.5. After adjusting for confounding variables, patients in the highest LAR quartile had a higher risk of AKI than those in the lowest LAR quartile within 2 days and 7 days, with odds ratios of 1.37 (95% confidence interval [CI]: 1.23–1.52) and 1.95 (95% CI: 1.72–2.22), respectively. The adjusted odds of AKI within 2 and 7 days were 1.16 (95% CI: 1.12–1.20) and 1.29 (95% CI: 1.24–1.35) for each 1 unit increase in LAR(log2), respectively.

Conclusion

This study demonstrated that elevated LAR was associated with poor prognosis in patients with sepsis. The risk of AKI and in-hospital mortality increased, the need for RRT increased, and the chance of recovery of renal function decreased with the increase of LAR.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Emergency, First People’s Hospital of Foshan, No.18 Lingnan Avenue North, Chancheng District, Foshan, 528000, Guangdong Province, China

    Weigan Xu, Jianyang Huo, Qiaohua Hu, Jingtao Xu, Guojun Chen, Jierong Mo & Tianen Zhou

  2. First People’s Hospital of Foshan, Foshan, Guangdong Province, China

    Jun Jiang

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  1. Weigan Xu
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Contributions

WX and JJ designed this study. JX, QH and TZ conducted the collection and analysis of data. WX drafted the manuscript. JH, GC and JM analyzed and interpreted the results. All authors have reviewed the manuscript.

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Correspondence to Weigan Xu.

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The Institutional Review Boards of the Massachusetts Institute of Technology exempted the MIMIC IV database from ethics review, given that patient information was hidden to protect privacy.

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Xu, W., Huo, J., Hu, Q. et al. Association between lactate dehydrogenase to albumin ratio and acute kidney injury in patients with sepsis: a retrospective cohort study. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02500-y

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