Abstract
Purpose: Considerable evidence suggests that inflammation and malnutrition are common in patients with acute kidney injury (AKI) and correlated with mortality of various diseases. Despite this, few studies have reported the underlying predictive effects of inflammatory and nutritional markers in combination on the mortality of AKI patients. Herein, we aimed to explore the values of PCT and CRP as well as the ratios of PCT/Alb and CRP/Alb in the poor prognosis of patients with sepsis-induced AKI.Patients and Methods: A total of 171 patients with AKI, caused by abdominal infection-evoked sepsis, were retrospectively studied and divided into a survival group (107 cases) and a non-survival group (64 cases). Univariate analysis was used to compare the clinical data of the two groups. Multivariate logistic regression analysis was used to analyze the independent risk factors of poor prognosis in patients with sepsis-induced AKI. The ROC curve was used to evaluate the diagnostic value of PCT, CRP, PCT/Alb, and CRP/Alb in the poor prognosis of patients with sepsis-induced AKI.Results: Univariate analysis revealed that the values of PCT, CRP, CRP/Alb, and PCT/Alb were significantly different between AKI survival and non-survival groups, and further analysis found that PCT and PCT/Alb were independent risk factors for poor prognosis in patients with sepsis-induced AKI after adjusting with age and gender. Of note, the predictive accuracy (0.864 vs. 0.807), specificity (83.2 vs. 69.2), and sensitivity (79.7 vs. 76.6) of PCT/Alb were all higher than that of the simple PCT.Conclusions: The ratio of PCT to Alb is an independent risk factor possessing a robust and accurate risk assessment for the poor prognosis of patients with sepsis-induced AKI, and it offers the potential to improve the management of this type of disease and a lower resultant mortality.
Highlights
Sepsis, a systemic inflammatory response syndrome caused by infection, is mainly characterized by excessive release of inflammatory mediators and cytokines, which subsequently result in life-threatening organ dysfunction, especially in the heart and kidney
The purpose of our study was to assess the correlation among inflammation markers Serum C reactive protein (CRP), procalcitonin (PCT), and nutritional marker albumin (Alb) and 90-day mortality in sepsis-induced AKI and to put more attention on the combined markers (CRP/Alb and PCT/Alb)
We found that the ratio of PCT/Alb and CRP/Alb in the non-survival group were both remarkably higher than that of the survival group [for PCT/Alb: 2.43 (2.93) vs. 0.29 (0.49), P < 0.001; for CRP/Alb: 10.81 (6.65) vs. 5.84 (5.58.), P < 0.001]
Summary
A systemic inflammatory response syndrome caused by infection, is mainly characterized by excessive release of inflammatory mediators and cytokines, which subsequently result in life-threatening organ dysfunction, especially in the heart and kidney. Albumin has effectively reduced the incidence of sepsis, sepsis shock still accounts for 62% of overall shock cases, with hospital mortality > 40% [1,2,3]. Of the intensive care unit (ICU) patients, intra-abdominal infection (IAI) is the primary cause of sepsis, with an overall mortality of 10.5% worldwide [4]. Owing to the hazardous effects of kidney sepsis, discovering robust predictive markers of mortality risk for sepsis-induced shock or AKI is imperative and will be beneficial for the management of such complications and future therapeutic intervention
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
