#6573 ASSOCIATION BETWEEN SERUM TOTAL PROTEIN-TO-ALBUMIN RATIO AND PROGNOSIS IN SEPTIC ACUTE KIDNEY INJURY PATIENTS

Abstract

Abstract Background and Aims Sepsis is the leading cause of acute kidney injury (AKI). Increasing evidence shows that serum total protein-to-albumin ratio (TAR) could serve as inflammation- and nutrition-based prognostic score. The purpose of this study was to assess the effect of TAR on predicting the clinical outcomes of septic AKI patients. Method A retrospective study between August 2015 and August 2021 was performed at West China Hospital of Sichuan University. The primary outcomes were 30-day and 90-day all-cause mortality of septic AKI patients. The secondary outcomes were septic shock, transfer to the intensive care unit, mechanical ventilation, requirement for renal replacement therapy, and stage 3 AKI. Results A total of 309 eligible patients with a median age of 58 years were enrolled. Among the patients, 70.2% were males. In multivariate analysis, after adjustments for age, sex, and other confounding factors, higher baseline TAR was associated with an increased risk of 30-day and 90-day all-cause mortality in septic AKI patients (HR 1.91, 95% CI 1.18–3.09, P = 0.008; HR 1.54, 95% CI 1.01-2.34, P = 0.043, respectively). Subgroup analysis revealed no significant interactions in most strata. We found no relationship between TAR and secondary outcomes. The Youden index of TAR was larger than total protein or albumin alone in predicting both 30-day and 90-day all-cause mortality. Conclusion Increased TAR is an independent predictor for 30-day and 90-day all-cause mortality in septic AKI patients. The predictive performance of TAR outperformed those of total protein and albumin. Further research is needed to corroborate our findings in other cohorts and to compare the predictive ability of baseline TAR and the change in TAR under treatments.